Diagnosis and treatment of acute low back pain


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Abstract

Low back pain (LBP) is frequent cause for visit to the doctor and common cause of disability. Modern experts’ recommendations for diagnostics and treatment of acute LBP are presented. Common mistakes, difficulties in diagnostics and treatment of acute LBP are discussed. Diagnosis of non - specific acute LBP is based on clinical examination and exclusion of specific causes of back pain. Instrumental studies are not needed in most cases of acute LBP. Key steps in the treatment of patients with acute non - specific LBP are to inform of patients about good prognosis of pain, to recommend daily activity and avoidance of bed rest, to prescribe nonsteroidal anti - inflammatory drug for pain reducing. Effectiveness of vitamins B in acute LBP is discussed.

About the authors

V A Parfenov

Sechenov First Moscow State Medical University (Sechenov University), Neurology and Neurosurgery Department

д.м.н., проф., зав. каф. нервных болезней и нейрохирургии лечебного факультета; ORCID: 0000-0002-1992-7960 Moscow, Russia

V A Golovacheva

Sechenov First Moscow State Medical University (Sechenov University), Neurology and Neurosurgery Department

Email: xoxo.veronicka@gmail.com
к.м.н., ассистент каф. нервных болезней и нейрохирургии лечебного факультета; ORCID: 0000-0002-2752-4109 Moscow, Russia

References

  1. Jordan K.P, Kadam U.T, Hayward R, et al. Annual consultation prevalence of regional musculoskeletal problems in primary care: an observational study. BMC Musculoskelet Disord. 2010;11:144. doi: 10.1186/1471-2474-11-144
  2. Andersson G.B. The epidemiology of spinal disorders. In: Frymoyer J.W, editor. The adult spine: principles and practice. 2nd ed. New York: Raven Press; 1997. Р. 93-141.
  3. Vos T, Flaxman A.D, Naghavi 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):2163-96. doi: 10.1016/S0140-6736(12)61729-2
  4. Подчуфарова Е.В., Яхно Н.Н. Боль в спине. М., 2010. 368 с.
  5. Парфенов В.А., Исайкин А.И. Боли в нижней части спины: мифы и реальность. М.: ИМА-ПРЕСС, 2016. 104 с.
  6. Парфенов В.А., Исайкин А.И. Боли в поясничной области. Библиотека практического врача. М.: МЕДпрес - информ, 2018. 200 с.
  7. Koes B.W, van Tulder M, Lin C.W, et al. An updated overview of clinical guidelines for the management of non - specific low back pain in primary care. Eur Spine J. 2010;19:2075-94. doi: 10.1007/s00586-018-5673-2
  8. Low back pain and sciatica in over 16s: assessment and management. NICE guideline [NG59]. Published date: November 2016. www.nice.org.uk/guidance/ng59/evidence. doi: 10.1016/j.jphys.2017.02.012
  9. Stochkendahl M.J, Kjaer P, Hartvigsen J, et al. National Clinical Guidelines for non - surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. Eur Spine J. 2017. doi: 10.1007/s00586-017-5099-2
  10. Qaseem A, Wilt T.J, Mc Lean R.M, Forciea M.A. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-30. doi: 10.7326/m16-2367
  11. Парфенов В.А., Яхно Н.Н., Кукушкин М.Л. и др. Острая неспецифическая (скелетно - мышечная) поясничная боль. Рекомендации Российского общества по изучению боли (РОИБ). Неврология, нейропсихиатрия, психосоматика. 2018;9(2):4-11. doi: 10.14412/2074-2711-2018-2-4-11
  12. Steffens D, Hancock M.J, Maher C.G, et al. Does magnetic resonance imaging predict future low back pain? A systematic review. Еur J Pain. 2014;18(6):755-65. doi: 10.1002/j.1532-2149.2013.00427.x
  13. Bardin L.D, King P, Maher C.G. Diagnostic triage for low back pain: a practical approach for primary care. Med J Aust. 2017;206(6):268-73. doi: 10.5694/mja16.00828
  14. Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24:769-81. doi: 10.1016/j.berh.2010.10.002
  15. Ash L.M, Modic M.T, Obuchowski N.A, Ross J.S, Brant-Zawadzki M.N, Grooff P.N. Effects of diagnostic information, per se, on patient outcomes in acute radiculopathy and low back pain. AJNR Am J Neuroradiol. 2008;29:1098-103. doi: 10.3174/ajnr.A0999
  16. Jarvik J.G, Hollingworth W, Martin B, et al. Rapid magnetic resonance imaging vs adiographs for patients with low back pain: a randomized controlled trial. JAMA. 2003;289:2810-8. doi: 10.1001/jama.289.21.2810
  17. Hong J-Y, Son K-S, Cho J.H, Lee J.H. An Updated Overview of Low Back Pain Management in Primary Care. Asian Spine J. 2017;11(4):653-60. doi: 10.4184/asj.2017.11.4.653
  18. Насонов Е.Л., Яхно Н.Н., Каратеев А.Е. и др. Общие принципы лечения скелетно - мышечной боли: междисциплинарный консенсус. Научно - практическая ревматология. 2016;54(3):247-65. doi: 10.14412/1995-4484-2016-247-265
  19. Каратеев А.Е., Алексеева Л.И., Цурган А.В., Гонтаренко Н.В. Терапия острой/подострой скелетно - мышечной боли: результаты наблюдательного исследования АЛИСА (Анальгетическое Лечение с Использованием Системного Алгоритма). Терапевтический архив. 2017;89(12-2):175-84. doi: 10.17116/terarkh20178912175-184
  20. Каратеев А.Е., Погожева Е.Ю., Филатова Е.С. и др. Факторы, влияющие на результаты анальгетической терапии. Результаты российского многоцентрового исследования НОТА (НПВП для Обезболивания: Терапевтический Анализ). Терапевтический архив. 2018;90(6):65-73. doi: 10.26442/terarkh201890665-73
  21. Kuritzky L, Samraj G.P. Nonsteroidal anti - inflammatory drugs in the treatment of low back pain. J Pain Res. 2012;5:579-90. doi: 10.2147/jpr.s6775
  22. Piccoliori G, Engl A, Gatterer D, et al. Management of low back pain in general practice - is it of acceptable quality: an observational study among 25 general practices in South Tyrol (Italy). BMC Family Pract. 2013;14:148-56. doi: 10.1186/1471-2296-14-148
  23. Williams C.M, Maher C.G, Mc Lachlan A.J, et al. Efficacy of paracetamol for acute low - back pain: a double - blind, randomised controlled trial. Lancet. 2014;384:1586-96. doi: 10.1016/s0140-6736(14)60805-9
  24. Machado G.C, Maher C.G, Ferreira P.H, et al. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta - analysis of randomised placebo controlled trials. BMJ. 2015 Mar 31;350:h1225. doi: 10.1136/bmj.h1225
  25. Liu L, Skinner M, Mc Donough S, et al. Acupuncture for Low Back Pain: An Overview of Systematic Reviews. Evid Based Complement Alternat Med. 2015; ID 328196. 18 p. doi: 10.1155/2015/328196
  26. Furlan A D, Giraldo M, Baskwill A, et al. Massage for low - back pain. Cochrane Database Syst Rev. 2015;CD001929. doi: 10.1155/2015/328196
  27. Franca D.S, Souza A.L, Almeida K.R, et al. B vitamins induce an antinoceceptive effect in the acetic acid and formaldehyde models of nociception in mice. Eur J Pharmacol. 2001;421(3):157-64. doi: 10.1016/s0014-2999(01)01038-x
  28. Sánchez-Ramírez G.M, Caram-Salas N.L, Rocha-Gonzáles H.I, et al. Benfotiamine relieves inflamatory and neuropathic pain in rats. Eur J Pharmacol. 2006;150(1-2):48-53. doi: 10.1016/j.ejphar.2005.11.016
  29. Bartoszyk G.D. The interactions of vitamins B1, B6 and B12 with non - steroidal antirheumatic and analgesic drugs: animal experiment results. Klin Wochenschr. 1990 Jan 19;68(2):121-4. doi?
  30. Jurna I, Carlsson K.H, Komen W, Bonke D. Acute effects of vitamin B6 and fixed combinations of vitamin B1, B6 and B12 on nociceptive activity evoked in the rat thalamus: dose - response relationship and combinations with morphine and paracetamol. Klin Wochenschr. 1990 Jan 19;68(2):129-35. doi?
  31. Mibielli M, Geller M, Cohen J.C, et al. Diclofenac Plus B Vitamins Versus Diclofenac Monotherapy in Lumbago: the DOLOR Study. Curr Med Res Opin. 2009;25(11):2589-99. doi: 10.3111/13696990903246911
  32. Головачева В.А., Головачева А.А. Терапия острой неспецифической боли в спине: новые возможности. Неврология, нейропсихиатрия, психосоматика. 2018;10(4):123-8. doi: 10.14412/2074-2711-2018-4-123-128
  33. Данилов А.Б. Лечение острой боли в спине: витамины группы «В» или НПВП? Русский медицинский журнал. 2010;0:35-40.
  34. Камчатнов П.Р. Повышение эффективности и безопасности лечения пациентов с поясничной болью. Журнал неврологии и психиатрии им. С.С. Корсакова. 2016;116(10):28-33. doi: 10.17116/jnevro201611610128-33
  35. Buesing S, Costa M, Schilling J.M, Moeller-Bertram T. Vitamin B12 as a Treatment for Pain. Pain Phys. 2019 Jan;22(1):E45-E52. doi?
  36. Steffens D, Maher C.G, Pereira L.S, et al. Prevention of Low Back Pain: A Systematic Review and Meta - analysis. JAMA Intern Med. 2016;176(2):199-208. doi: 10.1001/jamainternmed.2015.7431
  37. Герасимова О.Н., Парфенов В.А., Калимеева Е.Ю. Лечение пациентов с острой и подострой дорсалгией. Неврология, нейропсихиатрия, психосоматика. 2018;9(3):36-41. doi: 10.14412/2074-2711-2018-3-36-41

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