Analgesic treatment, by using a systemic algorithm

Евгеньевич, Каратеев Андрей; Алексеева, Л. И.

doi:10.14412/1996-7012-2015-2-37-50

Cited by 5 publications

References 68 publications

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Spinal pain: causes and treatment policy

Олюнин¹

2018

RJTAO

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Chronic pain in the spine is one of the most urgent medical problems. Clinical and instrumental studies fail to reveal that most patients with back pain have any structural changes that may contribute to its occurrence. It is considered that the pain may be caused by the strain of muscles and ligaments located in the lower back, by the overload of these segments, and by detraining. If the cause of the pain syndrome cannot be established, the pain in the spine is regarded as nonspecific. It is believed that behavioral, psychological, and social factors can play an important role in the development of pain. Therefore, current guidelines propose to apply a biopsychosocial approach in patients with back pain. At the same time, much attention is paid to patient self-treatment, exercise therapy, psychotherapy, and some other auxiliary methods. When nonpharmacological interventions are insufficiently effective, drug therapy is indicated. Nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol, opioid analgesics, and muscle relaxants are used to treat nonspecific spinal pain. Pharmacotherapy is usually initiated with the use of NSAIDs. They can effectively relieve pain sndrome, but the possibilities of their use in a large proportion of patients are significantly limited due to adverse reactions (ARs). Gastrointestinal and cardiovascular ARs most commonly occur. The likelihood of ARs can be substantially reduced by the use of aceclofenac (AirtalR) that is characterized by a favorable gastrointestinal and cardiovascular safety profile. Paracetamol, opioid analgesics, and muscle relaxants are also used in the combination treatment of these patients.

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Spinal pain: causes and treatment policy

Олюнин¹

2018

RJTAO

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Central muscle relaxants in rheumatology practice

Polishchuk¹,

Potapova²,

Каратеев³

2021

Sovremennaâ revmatologiâ

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The article describes the general principles of the treatment of musculoskeletal pain, discusses modern approaches to the treatment of osteoarthritis (OA) and nonspecific back pain (NBS). The issues discussed are: the efficacy and tolerability of the combined use of non-steroidal anti-inflammatory drugs (NSAIDs) of predominantly selective action (aceclofenac) and a centrally acting muscle relaxant (tolperisone) in the treatment of OA and NBS. Two clinical observations are presented that confirm the benefits of combined administration of NSAIDs and muscle relaxants in the treatment of OA and NBS. The efficacy and favorable safety profile of aceclofenac has been demonstrated in patients with comorbid diseases. Tolperisone has shown its efficacy both as a mean of controlling pain associated with muscle tension, and as an element of combination therapy not only for NBS, but also for OA.

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Acute musculoskeletal neck and back pain

Maksimov

Khaibullina

2021

Medicinskij sovet

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Back and neck pain is widespread in the population. Preferably, patients of working age are sick, which leads to serious economic losses. The transition of pain from acute to chronic increases financial costs, so effective treatment of back pain is an important medical, social and economic problem. Musculoskeletal pain (MSP) prevails among all types of back pain. The source of the MSP can be various structures of the musculoskeletal system: bones, joints, muscles, fascia, tendons, ligaments, intervertebral discs. The provoking factors for the development of the MSP are static and dynamic overloads arising from physical work, long stay in a fixed posture, unprepared movements, hypothermia, vibrations. The leading diagnostic method for the MSP is a physical research of a patient which includes a detailed collection of complaints and anamnesis, inspection in statics and dynamics, carrying out global and special tests, neuroorthopedic and neurological research. In most cases, the analysis of the results obtained allows you to set a clinical diagnosis without appointing additional research methods. Two cases of acute MSP with different localization, clinical manifestations and flow are offered to the discussion. In the first case, the process was localized in the muscles of the law back. In the second patient, the muscular tonic syndrome developed in the muscles of the neck and shoulder belt and was supported by functional blockades of the vertebral motor segments. For the treatment of both patients, NSAID, muscle relaxant, glucocorticoid, as well as non-drug therapy methods were used. For local injection therapy, a drug group of glucocorticoids was used, having a sodium phosphate and betamethazone dipropionate as part of the sodium betamethasone. The combination of two betamethazone salts provides both the rapid and prolonged effect of the drug, which makes it reasonable to use it with acute musculoskeletal pain.

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Analgesic treatment, by using a systemic algorithm

Cited by 5 publications

References 68 publications

Spinal pain: causes and treatment policy

Spinal pain: causes and treatment policy

Central muscle relaxants in rheumatology practice

Acute musculoskeletal neck and back pain

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