Treatment approach for managing low back pain
https://doi.org/10.21518/2079-701X-2016-8-76-80
Abstract
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.
About the Author
V. A. Parfyonov
First Moscow State Medical University named after I.M. Sechenov
Russian Federation
Russian Federation
References
1. Jordan KP, Kadam UT, Hayward R, et al. Annual consultation prevalence of regional musculoskeletal problems in primary care: an observational study. BMC Musculoskelet Disord, 2010, 11: 144.
2. Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol, 2010, 24: 769-781.
3. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2012, 380(9859): 2163-2196.
4. Hestbaek L, Leboeuf YC, Manniche C: Low back pain: what is the longterm course? A review of studies of general patient populations. Eur Spine J, 2003, 12: 149-165.
5. van Tulder MW, Becker A, Bekkering T et al. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J, 2006, 15(Suppl. 2): 169-191.
6. Airaksinen O, Brox JI, Cedraschi C et al. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J, 2006, 15(Suppl. 2): 192-300.
7. Chou R, Oaseem A, Snow V et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med, 2007, 147: 478-491.
8. Koes BW, van Tulder M, Lin C-WC et al. An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J, 2010, 19: 2075-2094.
9. Подчуфарова Е.В., Яхно Н.Н. Боль в спине. М., 2010, 368 с.
10. Chou R, Baisden J, Carragee EJ et al. Surgery for low back pain: a review of the evidence for an American Pain Society Clinical Practice Guideline. Spine, 2009, 34: 1094-1109.
11. Chou R, Hashimoto R, Friedly J et al. Pain Management Injection Therapies for Low Back Pain. Agency for Healthcare Research and Quality (US), 2015 Mar 20.
12. Weinstein JN, Tosteson TD, Lurie JD et al. Surgical vs Nonoperative Treatment for Lumbar Disk Herniation: The Spine Patient Outcomes Research Trial (SPORT): A Randomized Trial. JAMA, 2006, 296: 2441-2450.
13. Kuritzky L, Samraj G. P. Nonsteroidal anti-inflammatory drugs in the treatment of low back painJournal of Pain. Research, 2012, 5: 579-590.
14. Wojtulewsky JA, Schattenkirchner M, Barselo P et al. A siх-month double-blend trial to compare the efficacy and safety of me^^am 7.5 and nap^en 750 mg daily in patients with rheumatoid arthritis. Rheumatology, 1996,.35(Suppl. 1): 22-28.
15. Dequeker J, Hawkey C, Kahan A et al. Improvement in gastrointestinal tolerability of the selective cyclooxygenase (COX)-2 inhibitor, meloxicam, compared with piroxicam: results of the Safety and Efficacy Largescale Evaluation of COX- inhibiting Therapies (SELECT) trial in oste-oarthritis. Brit J Rheumatol, 1998, 37: 946-951.
16. Hawkey C et al. Gastrointestinal tolerability of meloxicam compared diclofenac in osteoarthri-tis patients. International MELISSA Study Group. Meloxicam Large-scale International Study Safety Assessment. Rheumatology (Oxford), 1999, 38: 793-798.
17. Dreiser RL, Parc JM, Velicitat P, Leu PL. Oral meloxicam is effective in acute sciatica: two randomized, double-blind trials versus placebo or diclofenac. Inflammation Res, 2001, 50(Suppl 1): 17-23.
18. Singh G, Lanes S, Triadafilopoulos S. Risk of serious upper gastrointestinal and cardiovascular thromboembolic complications with meloxicam. Am J Med, 2004, 117: 100-106.
19. Asghar W, Jamali F. The effect of COX-2-selective meloxicam on the myocardial, vascular and renal risks: a systematic review, Inflammopharmacology, 2015, 23(1): 1-16.
20. Парфенов В.А., Герасимова О.Н. Клинический опыт применения мелоксикама (Мовалиса) при неспецифической боли в спине и радикулопатии. Неврология, нейропсихиатрия, психосоматика, 2012, 2: 68-72.
Review
For citations:
Parfyonov VA. Treatment approach for managing low back pain. Meditsinskiy sovet = Medical Council. 2016;(8):76-80. (In Russ.) https://doi.org/10.21518/2079-701X-2016-8-76-80
Views:
644
Email this article 