Issues of therapy of chronic non-specific lumbodynia

Abstract

Low back pain or lumbalgia is one of the most common reasons for going to the doctor. Non-specific (musculoskeletal) pain is the most common (90%) cause of chronic lumbalgia. The chronic course of lumbalgia is determined not only by the anatomical sources of pain, but also by psychological and social factors that should be considered when managing patients. In the treatment of chronic nonspecific lumbalgia, a comprehensive multidisciplinary approach is effective, including optimization of drug therapy and motor activity, psychological methods (cognitive-behavioral therapy), an educational program, and manual therapy. When identifying common emotional disorders and insomnia, their therapy is required. Kinesitherapy (therapeutic gymnastics) is the most effective direction in the treatment of chronic nonspecific lumbalgia; оf primary importance are the regularity of physical exercises under the supervision of a specialist, the exclusion of sudden and excessive movements. In combination with activities, regular walking is highly effective. Cognitive-behavioral therapy is the most effective psychological direction in the management of patients with chronic nonspecific lumbalgia. It should be aimed not only at pain, but also at those often found in chronic non-specific lumbalgia insomnia, depression, and anxiety disorders. In some patients with damage to the facet joints, the sacroiliac joint, radiofrequency denervation or therapeutic blockades with anesthetics and corticosteroids can be used. Nonsteroidal anti-inflammatory drugs are used as medicines for chronic nonspecific lumbalgia, when prescribing them, it is necessary to take into account the presence and nature of risk factors for adverse events, concomitant diseases, interaction with other drugs The use of etoricoxib in chronic non-specific lumbalgia is discussed.