Preview

Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Acute nonspecific (musculoskeletal) low back pain Guidelines of the Russian Society for the Study of Pain (RSSP)

https://doi.org/10.14412/2074-2711-2018-2-4-11

Full Text:

Abstract

The examination of a patient with acute low back pain (LBP) includes the clarification of complaints and history data, brief physical and neurological examinations, and an assessment of danger symptoms. The diagnosis of acute nonspecific (musculoskeletal) LBP is based on the exclusion of a specific cause of pain (a potentially dangerous disease), discogenic radiculopathy, and lumbar spinal stenosis. If there is typical musculoskeletal pain and no danger symptoms, radiography, X-ray computed tomography, and magnetic resonance imaging are not recommended in the first 4 weeks of disease. Whether it is expedient to perform these techniques is considered when LBP persists over this time period. A patient with acute nonspecific (musculoskeletal) LBP should be informed about the favorable outcome of the disease and the need to maintain physical and social activities, to avoid bed rest, and, if possible, to continue professional activities. The lowest effective dose of nonsteroidal anti-inflammatory drugs for short-term duration, as well as muscle relaxants (the medium level of evidence) can be used to relieve pain. It is recommended that one should use an educational program (to prevent over-exercising and prolonged standing or sitting in static and awkward positions; to lift weights properly; etc.) to prevent recurrent LBP, as well as therapeutic exercises during a non-exacerbation period.

About the Authors

V. A. Parfenov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation


N. N. Yakhno
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Moscow 119021


M. L. Kukushkin
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia; Research Institute of General Pathology and Pathophysiology, Russian Academy of Sciences
Russian Federation
11, Rossolimo St., Moscow 119021; 8, Baltiyskaya St., Moscow 125315


M. V. Churyukanov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia; Acad. B.V. Petrovsky Russian Research Center of Surgery
Russian Federation
11, Rossolimo St., Moscow 119021; 2, Abrikosovsky Lane, Moscow 119991


O. S. Davydov
Z.P. Solovyov Research and Practical Center of Psychoneurology, Moscow Healthcare Department
Russian Federation
43, Donskaya St., Moscow 115419


V. A. Golovacheva
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Contact: Veronika Aleksandrovna Golovacheva

11, Rossolimo St., Moscow 119021



A. I. Isaikin
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Moscow 119021


E. E. Achkasov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Moscow 119021


G. Yu. Evzikov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Moscow 119021


A. E. Karateev
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
34A, Kashirskoye Shosse, Moscow 115552


F. A. Khabirov
Kazan State Medical Academy, Branch, Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
Russian Federation
36, Butlerov St., Kazan 420012


V. A. Shirokov
Ural State Medical University, Ministry of Health of Russia
Russian Federation
3, Repin St., Yekaterinburg 620028


References

1. Podchufarova EV, Yakhno NN. Bol' v spine [Back pain]. Moscow; 2010. 368 p.

2. Yakhno NN, editor. Bolevoi sindrom: patofiziologiya, klinika, lechenie. Klinicheskie rekomendatsii [Pain syndrome: pathophysiology, clinic, treatment. Clinical guidelines]. 2nd edition. Moscow: IMA-PRESS; 2014. 72 p.

3. Yakhno NN. Neurology of pain. Rossiiskii zhurnal boli. 2014; (2):3-5. (In Russ.).

4. Parfenov VA, Isaikin AI. Bol' v nizhnei chasti spiny: mify i real'nost' [Low back pain: myths and reality]. Moscow: IMA-PRESS; 2016. 104 p.

5. Jordan KP, Kadam UT, Hayward R, et al. Annual consultation prevalence of regional musculoskeletal problems in primary care: an observational study. BMC Musculoskelet Disord. 2010 Jul 2;11:144. doi: 10.1186/1471-2474-11-144.

6. Cassidy JD, Carroll LJ, Cote P. The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine (Phila Pa1976). 1998 Sep 1;23(17):1860-6; discussion 1867.

7. Walker BF. The prevalence of low back pain: A systematic review of the literature from 1966 to 1998. J Spinal Disord. 2000 Jun;13(3):205-17.

8. McIntosh G, Hall H. Low back pain (acute). BMJ Clin Evid. 2011 May 9;2011. pii: 1102.

9. Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012 Dec 15;380(9859): 2163-96. doi: 10.1016/S0140-6736(12)61729-2.

10. Erdes ShF. Nespetsificheskaya bol' v nizhnei chasti spiny. Klinicheskie rekomendatsii dlya uchastkovykh terapevtov i vrachei obshchei praktiki [Non-specific low back pain. Clinical guidelines for primary care physicians and general practitioners]. Moscow; 2008. 70 p.

11. Yakhno NN, Kukushkin ML, Churyukanov MV, Syrovegin AV. The results of open multicenter study «MERIDIAN» to assess the prevalence of pain syndromes in outpatient practice and therapeutic preferences of doctors. Rossiiskii zhurnal boli. 2012;(3):10-4. (In Russ.).

12. Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Aug 22;386(9995): 743-800. doi: 10.1016/S0140-6736(15)60692-4. Epub 2015 Jun 7.

13. Davydov OS. Prevalence of pain syndromes and their impact on the quality of life in the world and in Russia according to the study of the global burden of disease for the period from 1990 to 2013. Rossiiskii zhurnal boli. 2015; 3-4:5-12. (In Russ.).

14. Koes BW, van Tulder M, Lin CW, et al. An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J. 2010 Dec;19(12): 2075-94. doi: 10.1007/s00586-010-1502-y. Epub 2010 Jul 3.

15. Agence Nationale d'Accreditation et d'Evaluation en Sante. Guidelines department, diagnosis and management of acute low back pain (3 months) with or without sciatica & diagnosis, management and follow-up of patients with chronic low back pain. Paris; 2000. www.anaes.fr or www.sante.fr

16. Australian Acute Musculoskeletal Pain Guidelines Group. Evidence-based management of acute musculoskeletal pain. Bowen Hills: Australian Academic Press; 2003.

17. The Dutch Institute for Healthcare Improvement (CBO). Clinical guideline for non-specific low back pain. 2003.

18. National Health Committee. National Advisory Committee on Health and Disability, Accident Rehabilitation and Compensation Insurance Corporation. New Zealand Acute Low back pain Guide. Wellington; 2004.

19. Spain, the Spanish Back Pain Research Network. Guia de practica clinica. Lumbalgia Inespecifica. Version espnola de la Guia de Practica Clinica del Programa Europeo COST B13. 2005.

20. Negrini S, Giovannoni S, Minozzi S, et al. Diagnostic therapeutic flow-charts for low back pain patients: the Italian clinical guidelines. Eura Medicophys. 2006 Jun;42(2):151-70.

21. Van Tulder MW, Becker A, Bekkering T, et al. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J. 2006 Mar;15 Suppl 2: S169-91.

22. Drug Committee of the German Medical Society. Recommendations for treatment of low back pain. Koln; 2007.

23. Friedrich M, Likar R. Evidence and consensus based Austrian guidelines for management of acute and chronic nonspecific backache. Wien Klin Wochenschr. 2007;119(56):189-97.

24. Rossignol M, Arsenault B, Dionne C, et al. Clinic on lowback pain in interdisciplinary practice (clip) guidelines. 2007. http://www.santpub-mtl.qc.ca/clip

25. Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007 Oct 2;147(7):478-91.

26. Laerum E, Storheim K, Brox JI. New clinical guidelines for low back pain. Tidsskr Nor Laegeforen. 2007 Oct 18;127(20):2706.

27. Malmivaara A, Erkintalo M, Jousimaa J, et al. Aikuisten alaselkaђsairaudet. (Low back pain among adults. An update within the Finnish Current Care guidelines). Working group by the Finnish Medical Society Duodecim and the Societas Medicinae Physicalis et Rehabilitationis. Fenniae. Duodecim 2008;124:2237-9

28. Wong J, Cоtе P, Sutton DA, et al. Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur J Pain. 2017 Feb;21(2):201-216. doi: 10.1002/ejp.931. Epub 2016 Oct 6.

29. Low Back Pain and Sciatica in Over 16s: Assessment and Management. Clinical Guidelines. London: National Institute for Health and Care Excellence (UK); 2016. www.nice.org.uk/guidance/ng5

30. Stochkendahl M J, Kjaer P, Hartvigsen J, et al. National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. Eur Spine J. 2018 Jan;27(1):60-75. doi: 10.1007/s00586017-5099-2. Epub 2017 Apr 20.

31. Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-530. doi: 10.7326/M16-2367. Epub 2017 Feb 14.

32. Chou R, Loeser JD, Owens DK, et al; American Pain Society Low Back Pain Guideline Panel. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: An evidencebased clinical practice guideline from the American Pain Society. Spine (Phila Pa 1976). 2009 May 1;34(10):1066-77. doi: 10.1097/BRS.0b013e3181a1390d.

33. Cutforth G, Peter A, Taenzer P. The Alberta health technology assessment (HTA) ambassador program: The development of a contextually relevant, multidisciplinary clinical practice guideline for non-specific low back pain: A review. Physiother Can. 2011 Summer;63(3):278-86. doi: 10.3138/ptc.200939P. Epub 2011 Aug 10.

34. Livingston C, King V, Little A, et al. Evidence-Based Clinical Guidelines Project. Evaluation and Management of Low Back Pain: A Clinical Practice Guideline Based on the Joint Practice Guideline of the American College of Physicians and the American Pain Society (Salem, Oregon: Office for Oregon Health Policy and Research). 2011.

35. Bardin LD, King P, Maher CG Diagnostic triage for low back pain: a practical approach for primary care. Med J Aust. 2017 Apr 3;206(6):268-273.

36. World Health Organization. International statistical classification of disease and relation health problems. 10th ed. Geneva: World Health Organization; 1992.

37. Tavee JO, Levin KH. Low Back Pain. Continuum (Minneap Minn). 2017 Apr;23(2, Selected Topics in Outpatient Neurology):467486. doi: 10.1212/CON.0000000000000449.

38. Petersen T, Laslett M, Juhl C.Clinical classification in low back pain: best-evidence diagnostic rules based on systematic reviews. BMC Musculoskelet Disord. 2017 May 12;18(1):188. doi: 10.1186/s12891-017-1549-6.

39. Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):769-81. doi: 10.1016/j.berh.2010.10.002.

40. Henschke N, Kuijpers T, Rubinstein SM, et al. Injection therapy and denervation procedures for chronic low-back pain: a systematic review. Eur Spine J. 2010 Sep;19(9):1425-49. doi: 10.1007/s00586-010-1411-0. Epub 2010 Apr 29.

41. Roudsari B, Jarvik JG. Lumbar Spine MRI for Low Back Pain: Indications and Yield. AJR Am J Roentgenol. 2010 Sep;195(3):550-9. doi: 10.2214/AJR.10.4367.

42. Steffens D, Hancock MJ, Maher CG, et al. Does magnetic resonance imaging predict future low back pain? A systematic review. Eur J Pain. 2014 Jul;18(6):755-65. doi: 10.1002/j.1532-2149.2013.00427.x. Epub 2013 Nov 26.

43. Andersen JC. Is Immediate Imaging Important in Managing Low Back Pain? J Athl Train. 2011 Jan-Feb;46(1):99-102. doi: 10.4085/1062-6050-46.1.99.

44. Hong JY, Son KS, Cho JH, Lee JH. An Updated Overview of Low Back Pain Management in Primary Care. Asian Spine J. 2017 Aug;11(4):653-660. doi: 10.4184/asj.2017.11.4.653. Epub 2017 Aug 7.

45. Jenkins HJ, Hancock MJ, Maher CG, et al. Understanding patient beliefs regarding the use of imaging in the management of low back pain. Eur J Pain. 2016 Apr;20(4):573-80. doi: 10.1002/ejp.764. Epub 2015 Aug 18.

46. Balague F, Mannion AF, Pellise F, et al. Non-specific low back pain. Lancet. 2012 Feb 4;379(9814):482-91. doi: 10.1016/S01406736(11)60610-7. Epub 2011 Oct 6.

47. Menezes Costa LC, Maher CG, Hancock MJ, et al. The prognosis of acute and persistent low-back pain: a meta-analysis. CMAJ. 2012 Aug 7;184(11):E613-24. doi: 10.1503/cmaj.111271. Epub 2012 May 14.

48. Henschke N, Maher CG, Refshauge KM, et al. Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study. BMJ. 2008 Jul 7;337:a171. doi: 10.1136/bmj.a171.

49. Menezes Costa LC, Maher CG, McAuley JH, et al. Prognosis for patients with chronic low back pain: inception cohort study. BMJ. 2009 Oct 6;339:b3829. doi: 10.1136/bmj.b3829.

50. Martinez-Quinones JV, Aso-Escario J, Consolini F, Arregui-Calvo R. Spontaneous regression from intervertebral disc herniation. Propos of a series of 37 cases. Neurocirugia (Astur). 2010 Apr;21(2):108-17.

51. Chiu CC, Chuang TY, Chang KH, et al. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil. 2015 Feb;29(2):184-95. doi: 10.1177/0269215514540919. Epub 2014 Jul 9.

52. Macki M, Hernandez-Hermann M, Bydon M, et al. Spontaneous regression of sequestrated lumbar discherniations: Literature review. Clin Neurol Neurosurg. 2014 May;120:136-41. doi: 10.1016/j.clineuro.2014.02.013. Epub 2014 Feb 25.

53. Mehmet T, Inci BA, Mustafa G, Adem Bozkurt A. Spontaneous Regression of Lumbar Disc Herniation After weight Loss: Case Report. Turk Neurosurg. 2015;25(4):657-61. doi: 10.5137/1019-5149.JTN.9183-13.1.

54. Yang X, Zhang Q, Hao X, et al. Spontaneous regression of herniated lumbar discs: Report of one illustrative case and review of the literature. Clin Neurol Neurosurg. 2016 Apr;143:86-9. doi: 10.1016/j.clineuro.2016.02.020. Epub 2016 Feb 16.

55. Waddel G. The back pain revolution. Churchill Livingstone; 1998.

56. Oleske DM, Lavender SA, Andersson GB, Kwasny MM. Are back supports plus education more effective than education alone in promoting recovery from low back pain?: Results from a randomized clinical trial. Spine (Phila Pa 1976). 2007 Sep 1;32(19):2050-7.

57. Khabirov FA. Rukovodstvo po klinicheskoi nevrologii pozvonochnika [Guidelines for clinical neurology of the spine]. Kazan': Meditsina; 2006. 520 p.

58. Khabirov FA, Khabirova YuF. Bol' v shee i spine: rukovodstvo dlya vrachei [Neck and back pain: a guide for doctors]. Kazan': Meditsina; 2014. 504 p.

59. Furlan AD, Giraldo M, Baskwill A, et al. Massage for low-back pain. Cochrane Database Syst Rev. 2015 Sep 1;(9):CD001929. doi: 10.1002/14651858.CD001929.pub3.

60. Bogduk N, McGuirk B. Medical management of acute at chronic low back pain. Amsterdam: Elsevier; 2002.

61. Kuritzky L, Samraj GP. Nonsteroidal antiinflammatory drugs in the treatment of low back pain. J Pain Res. 2012;5:579-90. doi: 10.2147/JPR.S6775. Epub 2012 Nov 28.

62. Roelofs PD, Deyo RA, Koes BW, et al. Non-steroidal anti-inflammatory drugs for low back pain. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD000396. doi: 10.1002/14651858.CD000396.pub3.

63. Nasonov EL, Yakhno NN, Karateev AE, et al. General principles of treatment for musculoskeletal pain: interdisciplinary consensus. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2016;54(3):247-65. (In Russ.)]. doi: 10.14412/1995-4484-2016-247-265

64. Kukushkin ML, Brylev LV, Laskov VB, et al. he results of a randomized double-blind parallel study of the efficacy and safety of tolperisone in patients with acute non-specific low back pain. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2017;117(11):69-78. (In Russ.).

65. van Tulder MW, Touray T, Furlan AD, Solway S, Bouter LM. Muscle relaxants for non-specific low back pain. Cochrane Database Syst Rev. 2003;(2):CD004252.

66. Pareek A, Chandurkar N, Chandanwale AS, et al. Aceclofenac-tizanidine in the treatment of acute low back pain: a double-blind, doubledummy, randomized, multicentric, comparative study against aceclofenac alone. Eur Spine J. 2009 Dec;18(12):1836-42. doi: 10.1007/s00586-009-1019-4. Epub 2009 May 7.

67. Friedman BW, Dym AA, Davitt M, et al. Naproxen with cyclobenzaprine, oxycodone/ acetaminophen, or placebo for treating acute low back pain: a randomized clinical trial. JAMA. 2015 Oct 20;314(15):1572-80. doi: 10.1001/jama.2015.13043.

68. Williams CM, Maher CG, Latimer J, et al. Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial. Lancet. 2014 Nov 1;384(9954):1586-96. doi: 10.1016/S0140-6736(14)60805-9. Epub 2014 Jul 23.

69. Machado GC, Maher CG, Ferreira PH, et al. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials. BMJ. 2015 Mar 31; 350:h1225. doi: 10.1136/bmj.h1225

70. Burton AK, Balague F, Cardon G, et al; COST B13 Working Group on European Guidelines for Prevention in Low Back Pain. How to prevent low back pain? Best Pract Res Clin Rheumatol. 2005 Aug;19(4):541-55.

71. Steffens D, Maher CG, Pereira LS, et al. Prevention of Low Back Pain: A Systematic Review and Meta-analysis. JAMA Intern Med. 2016 Feb;176(2):199-208. doi: 10.1001/jamainternmed.2015.7431.


For citation:


Parfenov V.A., Yakhno N.N., Kukushkin M.L., Churyukanov M.V., Davydov O.S., Golovacheva V.A., Isaikin A.I., Achkasov E.E., Evzikov G.Y., Karateev A.E., Khabirov F.A., Shirokov V.A. Acute nonspecific (musculoskeletal) low back pain Guidelines of the Russian Society for the Study of Pain (RSSP). Neurology, Neuropsychiatry, Psychosomatics. 2018;10(2):4-11. (In Russ.) https://doi.org/10.14412/2074-2711-2018-2-4-11

Views: 392


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)