In 2018, published works that focus on European and American recommendations for the treatment of chronic back pain, where using opioid analgesics, it is recommended to take into account their complexity in multimorbid pathology in patients, since there is no effectiveness of pain reduction due to polypharmacotherapy. The peculiarity of the treatment is that the prevalence of musculoskeletal pain more often reaches its peak in elderly patients and is about 60%, which allows to establish an important direction in therapy - taking into account multimorbid pathology. It is necessary to take into account the accompanying chronic pathology because in patients with back pain hypertension occurs in 58.7%, chronic kidney disease occurs in 29.1% of patients, diabetes mellitus occurs in 23.1% of patients, depressive disorders occur in 15 , 3% of patients. Today it is proved that the common use of NSAIDs is critical for adverse events on the part of their use in patients with multimorbid pathology. In a number of clinical studies, the significant effect of tolperisone has been proven to relieve muscular spasm in acute and chronic back pain compared to tizanidine, where tolperisone is more often used in multimorbid pathology as a relaxant of skeletal muscles. The combination therapy strategy potentially represents a paradigm shift in rehabilitation therapy and can be very important for early intervention in spasticity management processes. In order to expand the scope of potential therapeutic use, the basic requirement for safe treatment is the quantitative basis of evidence of safety and efficacy, which, for example, is now presented in full on tolperisone hydrochloride. The new therapeutic options include a progressive addition of convergent therapy, where it is assumed that the potential for therapeutic purposes will be strengthened in view of the multimorbid pathology in the patient with back pain.

Improvements direction loop "Specialization reflex" lectures on "The use of acupuncture in gynecology" would help solve at least two problems: the decline of pharmacological burden on patients and thus minimizing possible complications and side effects of pharmacotherapy. On the other hand, the structure used in acupuncture treatment measures will undoubtedly increase the effectiveness of treatment of a wide range of pathological conditions in obstetrics and gynecology. Among the diseases in which treatment RT should take its rightful place, you can specify such as miscarriage, vomiting in pregnancy, preeclampsia, menstrual irregularities, algomenorrhea, endometriosis, premenstrual syndrome, pelvic pain, menopausal syndrome.

While neurological manifestations of osteochondrosis account for 60 to 70% of all diseases of the peripheral nervous system, vertebral radiculopathy make up 8 to 10% of other osteochondrosis complications. This often result in temporary and even permanent disability. There are three basic types of pain syndromes: somatogenic (nociceptive pain); neurogenic (neuropathic pain); psychogenic (psychogenic pain). The article provides clinical classification of vertebrogenic diseases of the peripheral nervous system and factors of vertebrogenic pain caused by degenerative changes of the spine. We have presented a quantitative and qualitative assessment of pain, special neurological and general neuroorthopedical methods of examination of patients with vertebral pain. Analyzed the clinical characteristics of muscle-tonic and dystrophic lesions of muscles and given differential diagnosis. For acute pain, treatment algorithms are suggested for vertebrogenic disease and radiculopathy, indicated possible side effects and complications.

Traditionally, the basic etiological concepts are considered in the views on the morphophysiological basis of hyperkinesis. Hyperkinesia is associated with hypotonia, a decrease in muscle tone, and hyperkinetic disorders are psychogenic and manifest in childhood. Hyperkinesia can be caused by a large number of various diseases, including metabolic disorders, endocrine disruption, hereditary disorders, vascular disorders or traumatic disorders. Other causes include intoxication of the nervous system, autoimmune diseases and infections. The classification of hyperkinesis is that hyperkinetic motions can be defined as any undesirable, excessive movements that can be distinguished from each other, based on the degree to which they are rhythmic, discrete, repetitive and random. When assessing a patient with suspected hyperkinesia, the doctor thoroughly records in the history of the disease a clear description of the movements, the medications prescribed in the past and present, the family history of the similar diseases, the history of the disease, including past infections, and any other influences. Treatment is aimed at reducing symptoms, restoring normal posture and improving the general condition of the patient.

According to the World Health Organization (WHO) annually in the world traumatic brain injury (TBI) are about 10 million people, of whom 1.5 million die (9.0% of all causes of mortality), and another 2.4 million are disabled. The incidence of TBI is 1,8-5,4 per 100 thousand population, according to WHO, every year it increases by 2%. In Ukraine there is a TBI each year almost 100-200 thousand. Victims, about 1 million. Establish disability due to TBI. In 50-90% of patients after brain injury neurological symptoms persist or new emerging neurological syndromes that cause disability in 45% of them. Every year in Ukraine die from TBI 10-11 thousand citizens, in accordance mortality of 2.4 cases per 10 thousand population (USA- 1.8-2.2 per 10,000 per year).