Back pain: from diagnosis to treatment

Abstract

In today ‘s world, back pain is a heavy burden and leads to a decrease in the working capacity, quality of life of people. The choice of tactics of treatment of pain in a back is defined by the pain reason: nonspecific pain, the specific pain caused by serious diseases or a compression of a root. The most frequent cause of back pain is nonspecific pain due to myofascial, muscular-tonic syndrome, facet syndrome, and sacral-iliac joint dysfunction in lower back pain. The article presents clinical symptoms of these syndrome, as well as techniques of neuroorthopedic examination, which allow to detect one or more abrasions of back pain. To prevent acute non-specific pain, it is recommended to prescribe non-steroidal anti-inflammatory drugs (NSAID) and muscle relaxants. Along with pharmacological treatments, treatment of patients with back pain should be more comprehensive and include cognitive-behavioral therapy and kinesiotherapy. Determination of the source of back pain in neuroorthopedic examination makes it possible to carry out local therapy in stages using blockages with local anesthetics and glucocorticoids. In case of insufficient effectiveness of blockades, it is possible to carry out radiofrequency denervation of facet joints or sacral-iliac). Clinical and neuroorthopedic examination of a patient with back pain with identification of sources of pain, analysis of the causes that led to its development, adequate treatment and recommendations to prevent repeated exacerbations can significantly reduce the risk of chronization of back pain and improve the quality of life of patients.

Keywords

• back pain
• sacroiliac joint dysfunction
• facet joints
• myofascial pain
• piriformis muscle syndrome
• fibromyalgia
• nsaids