[Improvement of the efficacy and safety of the treatment of patients with low back pain]

[Choosing of therapy for a patient with dorsalgia]

Dorsalgia is one of the most common skeletal muscle syndromes. Dorsalgia often develops in patients of older age groups with polymorbidity that requires the appointment of a large number of medications. In these conditions, the choice of effective and safe therapy is a difficult problem. Discusses management of a patient suffering dorsalgia with comorbidities, the risks of complications of therapy, possible safety treatment, in particular, through the use of combination therapy.

[Diagnosis and treatment of acute low back pain]

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.

Therapy for acute nonspecific back pain: new additional opportunities

Information about a favorable prognosis for a patient, recommendations for activities, and optimal pharmacotherapy are a mainstay in the effective treatment of acute nonspecific low back pain (NLBP). Standard pharmacotherapy for acute NLBP includes nonsteroidal anti-inflammatory drugs (NSAIDs). However, the longer their administration and larger doses, the higher the risk of side effects are. NSAIDs are contraindicated in some cases. In this connection, it has become necessary to search for new opportunities for the pharmacotherapy of acute NLBP. The results of experimental studies have demonstrated the analgesic and anti-inflammatory effects of high-dose B vitamins. Clinical trials have confirmed the efficacy of vitamin B complex (thiamine, pyridoxine, and cyanocobalamin) in the treatment of acute NLBP. The paper considers the practical significance of concomitant administration of B vitamins and NSAIDs in NLBP and notes the efficacy of milgamma used both alone and in combination with NSAIDs in the treatment of acute NLBP.

[Diagnosis and treatment of dorsopathy in patients with connective tissue dysplasia]

AIM

To study the pathogenesis, clinical manifestations and treatment of dorsopathy in patients with connective tissue dysplasia.

MATERIAL AND METHODS

Thirty-six patients, aged from 18 to 45 years, with lumbar-sacral radiculopathies associated with connective tissue dysplasia were examined. Detailed neurological examination, X-ray visualization and MRI of lumbosacral spine section, electromyographic assessment were performed. A five-point scale of neuro-vertebrological symptoms, the Numerical Rating Scale (NRS) and the Roland-Morris Low Back Pain and Disability Questionnaire were used.

RESULTS AND CONCLUSION

The results contained own data on the pathogenesis, clinical manifestations and treatment of dorsopathies in connective tissue dysplasias. Inclusion of long-acting pentoxifylline (vasonite) in the combined therapy in patients with dorsopathy associated with connective tissue dysplasia had a positive effect on disease course, decreased pain intensity and improved life activities.