Effectiveness of local injective therapy use for lumbosacral pain syndromes

Андреев, В. В.; Баранцевич, Е. Р.; Sychev, A. I.

doi:10.24884/1607-4181-2019-26-3-70-77

The Scientific Notes of the Pavlov university

2020

DOI: 10.24884/1607-4181-2019-26-3-70-77

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Effectiveness of local injective therapy use for lumbosacral pain syndromes

В. В. Андреев¹,

Е. Р. Баранцевич²,

A. I. Sychev³

Abstract: The objective of the study was to assess the effectiveness of local injection therapy in patients with lumbosacral pain during medical blockades.Methods and materials. The results of treatment of compressive lumbosacral radiculoischemia were studied in prospective trial with placebo control. One of the most valuable criteria of medical effectiveness was decrease of pain intensity by visual analog scale and McGill’s questionnaire. 58 patients were included in the study. Comparison between the groups was carried… Show more

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Cited by 2 publications

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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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Acute musculoskeletal neck and back pain

Maksimov

Khaibullina

2021

Medicinskij sovet

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The use of pharmacological blockades in the complex treatment of lumbosacral radiculoischemia in patients with discs hernias of large sizes

Андреев

Sychev

Баранцевич

2020

Rossijskij osteopaticheskij zhurnal

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Introduction. Lumbosacral dorsalgia is widespread and represents an actual problem. The greatest difficulties are noted in the treatment of patients with discs hernias of large size. Local injection therapy is actively used. The development of therapeutic methods in such patients remains relevant.The goal of research is to compare the effectiveness of pharmacological blockade in the complex treatment of spondylogenic lumbosacral radiculoischemia in patients with discs hernias of large size.Materials and methods. A prospective randomized controlled trial was conducted in March-November 2018 at the Neurological Department No. 2 of the Institute of neurology of the Pavlov First Saint Petersburg State Medical University. There were 58 patients with symptoms of lumbosacral radiculoischemia with discs hernias of large sizes. Depending on the used treatment method, the patients were divided into main and control groups. Each patient had 10 sessions of manual therapy lasting 20 minutes each. Sessions were held daily. Preformed physical factors were also used in all the observed patients. Preference was given to low-intensity laser therapy, the number of procedures was 10–15 with an interval on weekends, and the total duration of irradiation was no more than 20 minutes. Additionally, patients in the main group received local injections of diprospan and lidocaine, and patients in the control group received injections without the main substance. The intensity of pain was assessed by visual analog scale during the first day, as well as its intensity by the McGill questionnaire during 14 days.Results. The study included 24 men and 34 women with signs of compression radiculoishemias with discs hernias of large sizes. The level is lumbosacral (LIV–V, LV –SI ). When evaluating the data in the first hours and within 2 weeks, a significant decrease in the severity of pain syndrome was observed in comparison with the initial results in patients of both groups (p<0,05). The obsered data (pain intensity) significantly differed after 2 and 6 hours (p<0,001), as well as during 4, 7, and 8 days (p<0,01). The use of medication blocks with glucocorticoids has a more significant effect compared to the treatment regimen without the main substance (group 2) for 8–9 h (p<0,05) and 7-day treatment period (p<0,01).Conclusion. The medication blockades with glucocorticosteroids included in the complex treatment of patients with spondylogenic radiculoishemias with discs hernias of large sizes have a significantly more significant analgesic effect, while the effect is achieved in a short time. When using local injections with diprospan and lidocaine, the therapeutic effect appears gradually, and it persists for a long time — up to 2 weeks. The recommended number of injections is no more than 3 per course of treatment.

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Effectiveness of local injective therapy use for lumbosacral pain syndromes

Cited by 2 publications

References 10 publications

Acute musculoskeletal neck and back pain

Acute musculoskeletal neck and back pain

The use of pharmacological blockades in the complex treatment of lumbosacral radiculoischemia in patients with discs hernias of large sizes

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