medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2016-8-76-80medsovet-1310Research ArticleПрактикаPracticeВрачебная тактика при болях в нижней части спиныTreatment approach for managing low back painПарфеновВ. А.ParfyonovV. A.noemail@neicon.ruПервый Московский государственный медицинский университет им. И.М. СеченоваРоссияFirst Moscow State Medical University named after I.M. SechenovRussian Federation201630122016087680Copyright © Парфенов В.А., 20162016Парфенов В.А.Parfyonov V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/1310

Боли в нижней части спины представляют одну из наиболее частых причин обращения пациентов к врачу и их временной нетрудоспособности. Ведущее значение при обследовании имеют выяснение жалоб, сбор анамнеза, краткое соматическое и неврологическое обследования, что позволяет исключить признаки специфического заболевания, при этом в большинстве случаев нет необходимости в инструментальных методах обследования. При острой неспецифической боли в спине эффективны информация пациента о доброкачественном характере заболевания, высокой вероятности быстрого выздоровления, полезности сохранения активного образа жизни, использования для уменьшения боли нестероидных противовоспалительных препаратов (НПВП) и миорелаксантов. При хронической неспецифической боли в спине наиболее эффективно мульти-дисциплинарное лечение, которое включает лечебную гимнастику, когнитивно-поведенческую терапию, оптимизацию лекарственной терапии. При дискогенной радикулопатии также могут быть эффективны эпидуральные блокады кортикосте-роидов и анестетиков, только небольшой части пациентов необходимо хирургическое лечение. Представлены собственные данные об эффективности и безопасности НПВП, в частности мелоксикама (Мовалис), при болях в нижней части спины.

Low back pain is one of the most frequent causes of seeking doctor's aid and temporary disability of patients. The leading role in the examination belongs to clarification of complaints, medical history, quick physical and neurological examination which help to exclude presence of a specific disease, and in most cases there is no need for instrumental examination. Information about benign nature of the disease, high probability of quick recovery, benefits of adhering to an active lifestyle, use of pain relieving nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants could be of great value for patients with acute nonspecific back pain. To ensure efficacy, treatment for chronic non-specific back pain should be multidisciplinary and include physical therapy, cognitive-behavioral therapy, optimization of drug therapy. In case of discogenic radiculopathy, epidural corticosteroids and anesthetic could also be effective, and only a small proportion of patients need surgical treatment. The article provides the authors' findings on the efficacy and safety of NSAIDs, such as meloxicam (Movalis), for managing low back pain.

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The authors declare that there are no conflicts of interest present.