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Optimization of therapy in outpatients with chronic lumbago

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Lumbago is one of the most common lower back pain syndromes in medical practice, which is benign in the vast majority of cases and caused by spinal osteochondrosis, injury, and muscle strain or spasm. The primary task of examining a patient with lumbago is to be certain that the pain is musculoskeletal and unassociated with a potentially dangerous spinal disease requiring emergency special therapy.

Objective: to analyze the efficiency of treatment in outpatients with chronic lumbago.

Patients and methods. One hundred and four patients followed up by us in the Smolensk Kinesitherapy Center were examined. A study group comprised 84 patients (34 men and 50 women; mean age 44.2±1.29 years) with dorsalgia (pain duration ≥3 months; mean 7.6±6.83 years);a control group included 20 persons (10 men and  10 women; mean age 31.9±1.88 years) without pain in the back. Neurological examination and magnetic resonance imaging revealed nonspecific lower back pain in 67 (79.8%) patients and radiculopathy in 17 (20.2%). Combination treatment including pharmacotherapy and kinesitherapy was proposed in all the patients.

Results. 2.5–3 months after the initiation of therapy, pain regressed completely in 29 (34.5%) patients and was considerably alleviated in 27 (32.1%). Quality of life after therapy improved in the majority of patients. The patients in whom therapy was ineffective (n = 26; 31%) did not attend kinesitherapy classes and were cautious towards physical rehabilitation.

Discussion. The findings indicated the high efficiency of a comprehensive approach to treating chronic lumbago, which is largely associated with rational psychotherapy, early patient activation, and adaptive behavior training.

About the Author

A. A. Averchenkova
Smolensk Kinesitherapy Center, Smolensk, Russia 1, Aptechnaya St., Smolensk 214019
Russian Federation


1. Bigos SJ, Davis GE. Scientific basis for recommendation to eldery limited by low back symptoms. Clin Geriatr. 1999;7(7):41–53.

2. Парфенов ВА. Диагноз и лечение при болях в спине. Русский медицинский журнал. 2004;12(2):115–9. [Parfenov VA. The diagnosis and treatment at a back pains. Russkii meditsinskii zhurnal. 2004;12(2):115–9. (In Russ.)]

3. Герасимова ОН, Парфенов ВА. Клинический опыт применения мелоксикама (Мовалис®) при неспецифической боли в спине и радикулопатии. Неврология, нейропсихиатрия, психосоматика. 2012;(2):68–73.[Gerasimova ON, Parfenov VA. Clinical experience with meloxicam (Movalis®) in nonspecific back pain and radiculopathy. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;(2):68–73. (In Russ.)]. DOI:

4. Подчуфарова ЕВ, Яхно НН. Боль в спине. Москва: ГЭОТАР-Медиа; 2010. 368 с. [Podchufarova EV, Yakhno NN. Bol' v spine [Back pain]. Moscow: GEOTAR-Media; 2010. 368 p.]

5. Подчуфарова ЕВ. Лечение острых болевых синдромов пояснично-крестцовой локализации. Справочник поликлинического врача. 2006;4(4):57–60. [Podchufarova EV. Treatment of sharp pain syndromes of lumbar and sacral localization. Spravochnik poliklinicheskogo vracha. 2006;4(4):57–60. (In Russ.)]

6. Григорьева ВН. Психосоматические аспекты нейрореабилитации. В кн.: Хронические боли. Нижний Новгород: Изд-во НГМА; 2004.С. 78–144, 212–55. [Grigor'eva VN. Psychosomatic aspects of neurorehabilitation. In: Khronicheskie boli [Chronic pains]. Nizhnii Novgorod: Izd-vo NGMA; 2004. P. 78–144, 212–55.]

7. Gatchel RJ, Gardea MA. Lower back pain: psychosocial issues. Their importance in predicting disability, response to treatment and search for compensation. Neurologic clinics. 1999;17:149–66. DOI:

8. Kori SH, Miller RP, Todd DD. Kinesiophobia: а new view of chronic pain behavior. Pain Management. 1990;3:35–43.

9. Vlaeyen JW, KoleSnijders AM, Boeren RG, van Eek H. Fear of movement/(re)injury inchronic low back pain and its relation to behavioral performanсe. Pain. 995;62(3):363–72. DOI:

10. Кукушкин МЛ. Механизмы хронизации болевых синдромов. Патогенез. 2005;1:16–7. [Kukushkin ML. Mechanisms of synchronization of pain syndromes. Patogenez. 2005;3(1):16–7. (In Russ.)]

11. Кукушкин МЛ. Этиопатогенетические принципы лечения хронической боли. Русский медицинский журнал. 2007;15(10):827. [Kukushkin ML. Etiopatogenetic principles of treatment of chronic pain. Russkii meditsinskii zhurnal. 2007;15(10):827. (In Russ.)]

12. Von Roenn J, Paice JA, Preodor ME. Current diagnosis&treatment of pain. New York: Lange Medical Books/McGraw-Hill Medical Pub. Division; 2006. P. 364.

13. Данилов АБ, Голубев ВЛ. О концептуальной модели перехода острой боли в хроническую. Русский мединский журнал. Специальный выпуск. Болевой синдром.2009;17:11–4. [Danilov AB, Golubev VL. About conceptual model of transition of an acute pain to the chronic. Russkii medinskii zhurnal. Special issue «Bolevoi sindrom». 2009;17:11–4. (In Russ.)]

14. Парфенов ВА. Причины, диагностика и лечение боли в нижней части спины. Неврология, нейропсихиатрия и психосоматика. 2009;(1):1922. [Parfenov VA. Low back pain: causes, diagnosis, and treatment. Nevrologiya, neiropsikhiatriya i psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2009;(1):19–22. (In Russ.)]. DOI:

15. Last AR, Hulbert K. Chronic low back pain: evaluation and management. Am Fam Physician. 2009 Jun 15;79(12):1067–74.

16. Подчуфарова ЕВ. Боль в пояснично-крестцовой области: организация помощи пациентам в Великобритании. Неврология, нейропсихиатрия, психосоматика. 2014;(2):75–80. [Podchufarova EV. Lumbosacral pain: Delivery of care to patients in the United Kingdom. Nevrologiya, neiropsikhiatriya i psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2014;(2):75–80. (In Russ.)]. DOI:

17. Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine. 2000 Nov 15;25(22):2940–52.

18. Spielberger CD, Gorsuch RL, Lushene KE. State-trait anxiety inventory test manual for form X. Palo Alto, CA: Consulting Psychologists Press; 1970.

19. Ханин ЮП. Краткое руководство к применению шкалы реактивной и личностной тревожности Ч.Д. Спилбергера. Ленинград: ЛНИИФК, 1976. 18 с. [Khanin YuP. Kratkoe rukovodstvo k primeneniyu shkaly reaktivnoi i lichnostnoi trevozhnosti Ch.D. Spilbergera [The short management to application of a scale of jet and personal uneasiness of Ch.D. Spilberger]. Leningrad: LNIIFK, 1976. 18 p.]

20. Beck AT, Weissman A, Lester D, Trexler L. The measurement of pessimism: the hopelessness scale. J Consul Clin Psychol. 1974;42:861–5. DOI:

21. Белова АН, Шепетова ОН. Шкалы, тесты и опросники в медицинской реабилитации: руководство для врачей и научных работников. Москва: Антидор; 2002. 439 с. [Belova AN, Shepetova ON. Shkaly, testy i oprosniki v meditsinskoi reabilitatsii: Rukovodstvo dlya vrachei i nauchnykh rabotnikov [Scales, tests and questionnaires in medical rehabilitation: the management for doctors and scientists]. Moscow: Antidor; 2002. 439 p.]

22. Бубновский СM. Руководство по кинезитерапии. 2-е изд., доп. Москва; 2004. 112 с. [Bubnovskii SM. Rukovodstvo po kineziterapii [Guide to a kineziterapiya]. 2nd ed. Moscow; 2004. 112 p.]

23. Черненко ОА, Ахадов ТА, Яхно НН. Соотношение клинических данных и результатов магнитно-резонансной томографии при болях в пояснице. Неврологический журнал. 1996;2:12–6. [Chernenko OA, Akhadov TA, Yakhno NN. Ratio clinical yielded and results of a magnetic-resonance tomography at a aist pains. Nevrologicheskii zhurnal. 1996;2:12–6. (In Russ.)]

24. Boden SD, McCowin SR, Davis DO, et al. Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects. J Bone Joint Surg Am. 1994;72:1178–84.

25. Van Middelkoop M, Rubinstein SM, Kuijpers T, et al. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. [Review]. Eur Spine J. 2011;20(1):19–39.DOI:

26. Airaksinen O, Brox JI, Cedraschi C, et al. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(2):192–300. DOI:

27. Hayden JA, van Tulder MW, Malmivaara AV,et al. Meta-analysis: exercise therapy for nonspecific low back pain. Ann Intern Med. 2005;142:765–75. DOI:

For citation:

Averchenkova A.A. Optimization of therapy in outpatients with chronic lumbago. Neurology, Neuropsychiatry, Psychosomatics. 2014;6(4):40-45. (In Russ.)

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