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Nonspecific low back pain: Causes, clinical picture, diagnosis, and treatment

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In the current biopsychosocial model of back pain, there are biological (anatomic sources of pain), psychological and social components that promote its occurrence and maintenance. Nonspecific (musculoskeletal, mechanical) pain that is diagnosed, with a serious disease and radicular symptoms being ruled out, is encountered most commonly (in 85% of cases) in clinical practice. A group of patients with nonspecific back pain is very heterogeneous and needs differential treatment. The most common sources of back pain are abnormally changed discs, facet and sacroiliac joints, and muscles; however, it is often difficult to determine the main source of pain. International guidelines for the management of acute and chronic back pain have been elaborated, which assign an important role to the clarification of the benign pattern of pain to patients; their training; and recommendations for the maintenance of day-to-day activity. Medical treatment involves both nonselective and selective nonsteroidal anti-inflammatory drugs and myorelaxants as the drugs of choice. Non-drug treatments are actively used; these are manual therapy for acute pain, cognitive behavioral therapy, manual therapy, therapeutic exercises, reflex therapy, and yoga exercises for subacute and chronic pain. Whether blockades, ablations, minimally invasive neurosurgery, which are aimed at eliminating the main source of pain, is discussed if the treatment is ineffective.

About the Authors

A. I. Isaikin
I.M. Sechenov First Moscow State Medical University
Russian Federation

Department of Nervous System Diseases and Neurosurgery,

11, Rossolimo St., Moscow 119021

I. V. Kuznetsov
I.M. Sechenov First Moscow State Medical University
Russian Federation

Department of Nervous System Diseases and Neurosurgery,

11, Rossolimo St., Moscow 119021

A. V. Kavelina
I.M. Sechenov First Moscow State Medical University
Russian Federation

Department of Nervous System Diseases and Neurosurgery,

11, Rossolimo St., Moscow 119021

M. A. Ivanova
I.M. Sechenov First Moscow State Medical University
Russian Federation

Department of Nervous System Diseases and Neurosurgery,

11, Rossolimo St., Moscow 119021


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For citations:

Isaikin A.I., Kuznetsov I.V., Kavelina A.V., Ivanova M.A. Nonspecific low back pain: Causes, clinical picture, diagnosis, and treatment. Neurology, Neuropsychiatry, Psychosomatics. 2015;7(4):101-109. (In Russ.)

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