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Подходы к терапии нерадикулярной хронической/рецидивирующей боли в спине
Подходы к терапии нерадикулярной хронической/рецидивирующей боли в спине
Воробьева О.В. Подходы к терапии нерадикулярной хронической/рецидивирующей боли в спине. Consilium Medicum. 2015; 17 (2): 47–51. DOI: 10.26442/2075-1753_2015.2.47-51
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Аннотация
Приблизительно в 40% случаев причиной хронической боли в спине является фасеточный синдром, и этот процент увеличивается в старшей возрастной популяции пациентов. У больных спондилоартрозом боль возникает несколько раз в году, и ее эпизоды с каждым обострением имеют тенденцию к удлинению. В настоящее время в арсенале врача есть большое количество лекарственных средств для купирования болевого синдрома, отличающихся по быстроте наступления эффекта, выраженности обезболивающего действия и безопасности. В статье обсуждаются возможности использования хондропротекторов у больных с рецидивирующей болью в спине, в частности результаты крупномасштабного открытого проспективного исследования эффективности и безопасности комбинации глюкозамин и хондроитин сульфат (Артра).
Ключевые слова: нерадикулярная хроническая боль в спине, спондилоартроз, фасеталгия, глюкозамин и хондроитин сульфат (Артра).
Ключевые слова: нерадикулярная хроническая боль в спине, спондилоартроз, фасеталгия, глюкозамин и хондроитин сульфат (Артра).
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In approximately 40% of cases the cause of chronic back pain is the facet syndrome and this percentage increases in the older age population of patients. Patients in whom spondyloarthrosis pain occurs several times a year and episodes of exacerbation of pain tend towards elongation.
Currently the arsenal of a doctor has a large number of drugs for pain, which differ in speed of onset of effect, pronounced analgesic effect and safety. The article discusses the possibility of using chondroprotectors in patients with recurrent back pain, in particular the results of a large-scale open prospective study of efficacy and safety of glucosamine, chondroitin sulfate (arthritis).
Currently the arsenal of a doctor has a large number of drugs for pain, which differ in speed of onset of effect, pronounced analgesic effect and safety. The article discusses the possibility of using chondroprotectors in patients with recurrent back pain, in particular the results of a large-scale open prospective study of efficacy and safety of glucosamine, chondroitin sulfate (arthritis).
Key words: non-radicular chronic back pain, spondylarthrosis, facetalgy, glucosamine-chondroitin sulfate (Artra).
Полный текст
Список литературы
1. Pengel LHM, Herbert RD, Maher CG, Refshauge KM. Acute low back pain: systematic review of its prognosis. BMJ 2003; 327: 323–7.
2. Von Korff M, Saunders K. The course of back pain in primary care. Spine 1996; 21: 2833–9.
3. Hestbaek L, Leboeuf-Yde C, Manniche C. Low back pain: what is the long-term course? A review of studies of general patient populations. Eur Spine J 2003; 12: 149–65.
4. Jensen S. Back pain – clinical assessment. Australian Family Physician 2004; 33 (6): 393–401.
5. Bakker EW, Verhagen AP, van Trijffel E et al. Spinal mechanical load as a risk factor for low back pain: a systematic review of prospective cohort studies. Spine 2009; 34: E281–93.
6. Sim J, Lacey RJ, Lewis M. The impact of workplace risk factors on the occurence of neck and upper limb pain: a general population study. BMC Public Health 2006; 6: 234.
7. Staal J, de Bie R, de Vet H et al. Injection therapy for subacute and chronic low-back pain. Cochrane Database of Systematic Reviews 2008; 3. Art. No.: CD001824.
8. Niemisto L, Kalso E, Malmivaara A et al. Cochrane Collaboration Back Review Group. Radiofrequency denervation for neck and back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 2003; 28 (16): 1877–88.
9. Geurts J, van Wijk R, Stolker R, Groen G. Efficacy of radiofrequency procedures for the treatment of spinal pain: a systematic review of randomized clinical trials. Reg Anesth Pain Med 2001; 26 (5): 394–400.
10. Krane SM. Clinical importance of metalloproteinases and their inhibitors. Ann NY Acad Sci 1994; 732: 1–10.
11. Verbruggen G. Chondroprotective drugs in degenerative joint diseases. Rheumatology (Oxford) 2006; 45 (2): 129–38. Epub 2005.
12. Hochberg MC, Dougados M. Pharmacological therapy of osteoarthritis. Best Pract Res Clin Rheumatol 2001; 15 (15): 583–93.
13. Алексеева Л.И., Чичасова Н.В., Мендель О.И. Рациональный выбор базисной терапии при остеоартрозе. Результаты открытого рандомизированного многоцентрового исследования препарата АРТРА в России. РМЖ. Ревматология. 2005; 13 (24): 1637–40. / Alekseeva L.I., Chichasova N.V., Mendel' O.I. Ratsional'nyi vybor bazisnoi terapii pri osteoartroze. Rezul'taty otkrytogo randomizirovannogo mnogotsentrovogo issledovaniia preparata ARTRA v Rossii. RMZh. Revmatologiia. 2005; 13 (24): 1637–40. [in Russian]
14. Singh G, Alekseeva L, Alekseev V et al. Conbination treatment with glucosamine-chondroitin sulfate reduces pain, disability and NSAID consumption in patients with chronic low back pain: final results from a large, commute – based, pilot, open prospective study. Ann Rheum Dis 2014; 73 (Suppl. 2): 300. THU0341.
15. Saarto T, Wiffen PJ. Antidepressants for neuropathic pain. Cochrane Database Systematic Rev 2005; 3. Art. No.: CD005454.
16. Staiger TO, Gaster B, Sullivan MD, Deyo RA. Systematic review of antidepressants in the treatment of chronic low back pain. Spine 2003; 28 (22): 2540–5.
2. Von Korff M, Saunders K. The course of back pain in primary care. Spine 1996; 21: 2833–9.
3. Hestbaek L, Leboeuf-Yde C, Manniche C. Low back pain: what is the long-term course? A review of studies of general patient populations. Eur Spine J 2003; 12: 149–65.
4. Jensen S. Back pain – clinical assessment. Australian Family Physician 2004; 33 (6): 393–401.
5. Bakker EW, Verhagen AP, van Trijffel E et al. Spinal mechanical load as a risk factor for low back pain: a systematic review of prospective cohort studies. Spine 2009; 34: E281–93.
6. Sim J, Lacey RJ, Lewis M. The impact of workplace risk factors on the occurence of neck and upper limb pain: a general population study. BMC Public Health 2006; 6: 234.
7. Staal J, de Bie R, de Vet H et al. Injection therapy for subacute and chronic low-back pain. Cochrane Database of Systematic Reviews 2008; 3. Art. No.: CD001824.
8. Niemisto L, Kalso E, Malmivaara A et al. Cochrane Collaboration Back Review Group. Radiofrequency denervation for neck and back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 2003; 28 (16): 1877–88.
9. Geurts J, van Wijk R, Stolker R, Groen G. Efficacy of radiofrequency procedures for the treatment of spinal pain: a systematic review of randomized clinical trials. Reg Anesth Pain Med 2001; 26 (5): 394–400.
10. Krane SM. Clinical importance of metalloproteinases and their inhibitors. Ann NY Acad Sci 1994; 732: 1–10.
11. Verbruggen G. Chondroprotective drugs in degenerative joint diseases. Rheumatology (Oxford) 2006; 45 (2): 129–38. Epub 2005.
12. Hochberg MC, Dougados M. Pharmacological therapy of osteoarthritis. Best Pract Res Clin Rheumatol 2001; 15 (15): 583–93.
13. Alekseeva L.I., Chichasova N.V., Mendel' O.I. Ratsional'nyi vybor bazisnoi terapii pri osteoartroze. Rezul'taty otkrytogo randomizirovannogo mnogotsentrovogo issledovaniia preparata ARTRA v Rossii. RMZh. Revmatologiia. 2005; 13 (24): 1637–40. [in Russian]
14. Singh G, Alekseeva L, Alekseev V et al. Conbination treatment with glucosamine-chondroitin sulfate reduces pain, disability and NSAID consumption in patients with chronic low back pain: final results from a large, commute – based, pilot, open prospective study. Ann Rheum Dis 2014; 73 (Suppl. 2): 300. THU0341.
15. Saarto T, Wiffen PJ. Antidepressants for neuropathic pain. Cochrane Database Systematic Rev 2005; 3. Art. No.: CD005454.
16. Staiger TO, Gaster B, Sullivan MD, Deyo RA. Systematic review of antidepressants in the treatment of chronic low back pain. Spine 2003; 28 (22): 2540–5.
2. Von Korff M, Saunders K. The course of back pain in primary care. Spine 1996; 21: 2833–9.
3. Hestbaek L, Leboeuf-Yde C, Manniche C. Low back pain: what is the long-term course? A review of studies of general patient populations. Eur Spine J 2003; 12: 149–65.
4. Jensen S. Back pain – clinical assessment. Australian Family Physician 2004; 33 (6): 393–401.
5. Bakker EW, Verhagen AP, van Trijffel E et al. Spinal mechanical load as a risk factor for low back pain: a systematic review of prospective cohort studies. Spine 2009; 34: E281–93.
6. Sim J, Lacey RJ, Lewis M. The impact of workplace risk factors on the occurence of neck and upper limb pain: a general population study. BMC Public Health 2006; 6: 234.
7. Staal J, de Bie R, de Vet H et al. Injection therapy for subacute and chronic low-back pain. Cochrane Database of Systematic Reviews 2008; 3. Art. No.: CD001824.
8. Niemisto L, Kalso E, Malmivaara A et al. Cochrane Collaboration Back Review Group. Radiofrequency denervation for neck and back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 2003; 28 (16): 1877–88.
9. Geurts J, van Wijk R, Stolker R, Groen G. Efficacy of radiofrequency procedures for the treatment of spinal pain: a systematic review of randomized clinical trials. Reg Anesth Pain Med 2001; 26 (5): 394–400.
10. Krane SM. Clinical importance of metalloproteinases and their inhibitors. Ann NY Acad Sci 1994; 732: 1–10.
11. Verbruggen G. Chondroprotective drugs in degenerative joint diseases. Rheumatology (Oxford) 2006; 45 (2): 129–38. Epub 2005.
12. Hochberg MC, Dougados M. Pharmacological therapy of osteoarthritis. Best Pract Res Clin Rheumatol 2001; 15 (15): 583–93.
13. Алексеева Л.И., Чичасова Н.В., Мендель О.И. Рациональный выбор базисной терапии при остеоартрозе. Результаты открытого рандомизированного многоцентрового исследования препарата АРТРА в России. РМЖ. Ревматология. 2005; 13 (24): 1637–40. / Alekseeva L.I., Chichasova N.V., Mendel' O.I. Ratsional'nyi vybor bazisnoi terapii pri osteoartroze. Rezul'taty otkrytogo randomizirovannogo mnogotsentrovogo issledovaniia preparata ARTRA v Rossii. RMZh. Revmatologiia. 2005; 13 (24): 1637–40. [in Russian]
14. Singh G, Alekseeva L, Alekseev V et al. Conbination treatment with glucosamine-chondroitin sulfate reduces pain, disability and NSAID consumption in patients with chronic low back pain: final results from a large, commute – based, pilot, open prospective study. Ann Rheum Dis 2014; 73 (Suppl. 2): 300. THU0341.
15. Saarto T, Wiffen PJ. Antidepressants for neuropathic pain. Cochrane Database Systematic Rev 2005; 3. Art. No.: CD005454.
16. Staiger TO, Gaster B, Sullivan MD, Deyo RA. Systematic review of antidepressants in the treatment of chronic low back pain. Spine 2003; 28 (22): 2540–5.
________________________________________________
2. Von Korff M, Saunders K. The course of back pain in primary care. Spine 1996; 21: 2833–9.
3. Hestbaek L, Leboeuf-Yde C, Manniche C. Low back pain: what is the long-term course? A review of studies of general patient populations. Eur Spine J 2003; 12: 149–65.
4. Jensen S. Back pain – clinical assessment. Australian Family Physician 2004; 33 (6): 393–401.
5. Bakker EW, Verhagen AP, van Trijffel E et al. Spinal mechanical load as a risk factor for low back pain: a systematic review of prospective cohort studies. Spine 2009; 34: E281–93.
6. Sim J, Lacey RJ, Lewis M. The impact of workplace risk factors on the occurence of neck and upper limb pain: a general population study. BMC Public Health 2006; 6: 234.
7. Staal J, de Bie R, de Vet H et al. Injection therapy for subacute and chronic low-back pain. Cochrane Database of Systematic Reviews 2008; 3. Art. No.: CD001824.
8. Niemisto L, Kalso E, Malmivaara A et al. Cochrane Collaboration Back Review Group. Radiofrequency denervation for neck and back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 2003; 28 (16): 1877–88.
9. Geurts J, van Wijk R, Stolker R, Groen G. Efficacy of radiofrequency procedures for the treatment of spinal pain: a systematic review of randomized clinical trials. Reg Anesth Pain Med 2001; 26 (5): 394–400.
10. Krane SM. Clinical importance of metalloproteinases and their inhibitors. Ann NY Acad Sci 1994; 732: 1–10.
11. Verbruggen G. Chondroprotective drugs in degenerative joint diseases. Rheumatology (Oxford) 2006; 45 (2): 129–38. Epub 2005.
12. Hochberg MC, Dougados M. Pharmacological therapy of osteoarthritis. Best Pract Res Clin Rheumatol 2001; 15 (15): 583–93.
13. Alekseeva L.I., Chichasova N.V., Mendel' O.I. Ratsional'nyi vybor bazisnoi terapii pri osteoartroze. Rezul'taty otkrytogo randomizirovannogo mnogotsentrovogo issledovaniia preparata ARTRA v Rossii. RMZh. Revmatologiia. 2005; 13 (24): 1637–40. [in Russian]
14. Singh G, Alekseeva L, Alekseev V et al. Conbination treatment with glucosamine-chondroitin sulfate reduces pain, disability and NSAID consumption in patients with chronic low back pain: final results from a large, commute – based, pilot, open prospective study. Ann Rheum Dis 2014; 73 (Suppl. 2): 300. THU0341.
15. Saarto T, Wiffen PJ. Antidepressants for neuropathic pain. Cochrane Database Systematic Rev 2005; 3. Art. No.: CD005454.
16. Staiger TO, Gaster B, Sullivan MD, Deyo RA. Systematic review of antidepressants in the treatment of chronic low back pain. Spine 2003; 28 (22): 2540–5.
Авторы
О.В.Воробьева
Институт профессионального образования ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
ovvorobeva@mail.ru
Институт профессионального образования ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
ovvorobeva@mail.ru
________________________________________________
O.V.Vorobyova
Institute of Professional Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
ovvorobeva@mail.ru
Institute of Professional Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
ovvorobeva@mail.ru
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