medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-449medsovet-9721Research ArticleТЕРАПИЯ БОЛИPAIN THERAPYПоясничная радикулопатия у взрослых: клиника, диагностика, терапевтические подходыLumbar radiculopathy in adults: Clinical presentation, diagnosis, and approaches to treatmenthttps://orcid.org/0000-0002-7465-0677ПизоваН. В.PizovaN. V.

Пизова Наталия Вячеславовна, д.м.н., профессор кафедры нервных болезней с медицинской генетикой и нейрохирургией

150000, Ярославль, ул. Революционная, д. 5

Nataliia V. Pizova, Dr. Sci. (Med.), Professor of the Department of Nervous Diseases with Medical Genetics and Neurosurgery

5, Revolutsionnaya St., Yaroslavl, 150000

pizova@yandex.ruhttps://orcid.org/0000-0002-0522-675XПизовA. В.PizovA. V.

Пизов Александр Витальевич, к.б.н., доцент кафедры методики преподавания естественно-математических дисциплин в начальной школе

150000, Ярославль, ул. Республиканская, д. 108/1

Aleksandr V. Pizov, Cand. Sci. (Biol.), Associate Professor of the Department of Methods of Teaching Natural Sciences and Mathematics in Elementary Schools

108/1, Respublikanskaya St., Yaroslavl, 150000

avpizov@yandex.ruЯрославский государственный медицинский университетРоссияYaroslavl State Medical UniversityRussian FederationЯрославский государственный педагогический университет имени К.Д. УшинскогоРоссияYaroslavl State Pedagogical University named after K.D. UshinskyRussian Federation2025110120260226672Copyright © Пизова Н.В., Пизов A.В., 20262026Пизова Н.В., Пизов A.В.Pizova N.V., Pizov A.V.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/9721

Боль в нижней части спины считается важной проблемой общественного здравоохранения. Радикулопатия описывается как раздражение нервных корешков в результате различных патологий, включая грыжу межпозвоночного диска, костные шпоры, нестабильность позвоночника и травму. Что касается поясничной радикулопатии, которая развивается на фоне грыж межпозвоночных дисков, следует отметить, что это патология, при которой происходит изменение межпозвоночного диска вследствие разрыва фиброзного кольца и выпячивания пульпозного ядра. Клинически выявляется нарушение болевой, температурной, вибрационной и другой чувствительности (в т. ч. в виде парестезий, гиперили гипоалгезии, аллодинии, гиперпатии) в соответствующем дерматоме, снижение или выпадение сухожильных рефлексов, замыкающихся через соответствующий сегмент спинного мозга, гипотония и слабость мышц, иннервируемых данным корешком. Исследования показывают, что распространенность поясничной радикулопатии составляет до 5%, чаще встречаясь у мужчин в возрасте от 30 до 50 лет. К числу наиболее важных факторов риска развития радикулопатии на фоне межпозвоночной грыжи относятся возраст, острые травмы, поднятие тяжестей, скручивания, сгибания, вождение автомобиля, курение, беременность, сахарный диабет, повышенный индекс массы тела, артериальная гипертензия, гиперхолестеринемия и семейный анамнез. Учитывая патофизиологию и этиологию заболевания, весьма актуальным является проведение клинического опроса и серии диагностических тестов для подтверждения наличия данного клинического состояния. Лечение данной патологии может быть немедикаментозным, фармакологическим или хирургическим. Для купирования болевого синдрома препаратом первой линии являются нестероидные противовоспалительные средства.

Low back pain is considered a major public health issue. Radiculopathy describes irritation of nerve roots which can be a result of various pathologies, including disc herniation, bone spurs, spinal instability, and trauma. As regards lumbar radiculopathy, which develops due to disc herniation, it should be noted that this is a pathology, in which any changes in the intervertebral disc are caused by tears of the outer annulus and protrusion of the nucleus pulposis. Clinical manifestations include impaired pain, thermal, vibratory, and other sensitivity (including paresthesia, hyperor hypoalgesia, allodynia, and hyperpathy) in the respective dermatome, decreased or absent tendon reflexes which act through the specific spinal cord segment, as well as hypotonia and weakness of the muscles innervated by the root. Studies show that the prevalence of lumbar radiculopathy is up to 5%, and it is more common in men aged 30 to 50 years. The most important risk factors for radiculopathy with underlying intervertebral disc herniation include age, acute trauma, heavy lifting, twisting, bending, driving, smoking, pregnancy, diabetes, high body mass index, hypertension, hypercholesterolemia, and a family history. Given the pathophysiology and etiology of the disease, a clinical interview and a series of diagnostic tests are highly relevant to confirm the presence of this clinical condition. Many types of non-pharmacological, pharmacological, or surgical treatments are available for patients with this condition. Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered first-line management for pain relief.

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