Медицинский совет (Dec 2019)
Optimization of the management of a patient with a backache (with clinical observation)
Abstract
Back pain in terms of socio-economic losses over the past 5 years has come to the first place among the causes of disability, and therefore the problem of rapid effective anesthesia and rehabilitation of this large group of patients is topical. In most cases, the main sources of back pain are the structures of the musculoskeletal system, and the reasons are their microtraumatization due to sudden unprepared movements, prolonged stay in a static position, heavy physical labor. The task of clinical and instrumental examination is to exclude specific causes of dorsalgia. It is also important to present the results of the survey in an accessible form, in particular to correctly interpret the data from neuroimaging research methods. Adequate anaesthesia for acute back pain, informing the patient about the favorable prognosis of the disease and early motor activation are essential to prevent the transition of the physiological feeling of pain into the pathological process - chronic pain syndrome. When dealing with chronic pain, the interaction of specialists of different profiles in the multidisciplinary team is required. Kinesiotherapy, ergotherapy, cognitive-behavioural therapy are the main methods of non-drug treatment of lower back painIt is recommended that the patient maintains the usual level of physical activity and then increases it. It is necessary to teach the patient to correctly perform movements in the social, professional and domestic spheres, to explain how to avoid unsafe movements that can provoke dorsalgia. The article presents the observation of a patient with chronic back pain. Success in treatment has been achieved through effective anesthesia through rational selection of non-steroidal anti-inflammatory drugs (Dexalgin), local administration of local anesthetics to overcome kinesiophobia, and a combination of cognitive-behavioural therapy, kinesiotherapy, and ergotherapy.
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