Non-specific low back pain: principles and algorithms for successful management of patients in real clinical practice

Abstract

Non-specific low back pain (LBP) occurs in most people at least once in a lifetime. In city polyclinics, every fourth patient complains of LBP. During the COVID-19 pandemic, the prevalence of acute non-specific LBP and chronic LBP have increased due to physical inactivity, chronic stress, and anxiety. Musculoskeletal LBP is the second most common cause of disability. In this regard, it is important to consider modern principles for the diagnosis and treatment of non-specific LBP. Diagnostic algorithms, “red flags” (dangerous symptoms), “yellow flags” (chronification factors) in LBP are discussed. Own clinical cases of patients with LBP with “red flags” are presented. Effective drug and non-drug methods of treatment of LBP are considered: patient education, kinesiotherapy, cognitive-behavioral therapy, manual therapy, the use of non-steroidal anti-inflammatory drugs, muscle relaxants. The role of aceclofenac and tolperisone in the treatment of LBP is discussed, clinical studies data on the efficacy and safety of these drugs in pain syndromes are presented. We present our own clinical observation of the successful management of a patient with chronic non-specific LBP.

Keywords

• lower back pain
• musculoskeletal pain
• diagnostics
• “red flags”
• “yellow flags”
• treatment
• non-steroidal anti-inflammatory drugs
• muscle relaxants
• aceclofenac
• tolperisone
• kinesiotherapy