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Рецидивирующий фасеталгический синдром: анализ клинического случая
Рецидивирующий фасеталгический синдром: анализ клинического случая
Воробьева О.В. Рецидивирующий фасеталгический синдром: анализ клинического случая. Consilium Medicum. 2018; 20 (2): 106–111. DOI: 10.26442/2075-1753_2018_2.106-111
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Аннотация
Боль в спине часто рассматривается под диагностической рубрикой «неспецифическая» боль в связи с трудностью идентификации первичного источника боли в обыденной клинической практике. В статье на клиническом примере разбираются подходы к диагностике фасеточного синдрома. Представленный клинический случай демонстрирует возможности успешного комплексного консервативного лечения (базисный препарат Нимесил) рецидивирующего фасеталгического синдрома в условиях первичного поликлинического звена.
Ключевые слова: рецидивирующая боль в спине, субдиагноз боли в спине, фасеталгический синдром, Нимесил.
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Back pain is often regarded as “non-specific” pain that is explained by complicated identification of the primary pain source in everyday clinical practice. In the article approaches to facet syndrome diagnostics are discussed through the clinical case analysis. The presented clinical case demonstrates the capabilities of effective complex conservative treatment (using disease-modifying drug Nimesil) of recurrent facetalgy syndrome in primary health-care facilities.
Key words: recurrent, back pain subdiagnosis, facetalgy syndrome, Nimesil.
Полный текст
Список литературы
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________________________________________________
1. Cohen SP, Raja SN. Pathogenesis, diagnosis, and treatment of lumbarzygapo physial (facet) joint pain. Anesthesiology 2007; 106 (3): 591–614.
2. Manchikanti L, Singh V, Pampati V et al. Evaluation of the relative contributions of various structures in chronic low back pain. Pain Physician 2001; 4: 308–16.
3. Suri P, Hunter DJ, Rainville J et al. Presence and Extent of Severe Facet Joint Osteoarthritis Are Associated with Back Pain in Older Adults. Osteoarthritis Cartilage 2013; 21 (9): 1199–206. DOI: 10.1016/j.joca.2013.05.013
4. Popelianskii Ia.Iu., Shtulman D.R. Bolezni nervnoi sistemy. Pod red. N.N.Iakhno, D.R.Shtulmana. M.: Meditsina, 2001; s. 293–316. [in Russian]
5. Lee KE, Davis MB, Winkelstein BA. Capsular ligament involvement in the development of mechanical hyperalgesia after facet joint loading: behavioral and inflammatory outcomes in a rodent model of pain. J Neurotrauma 2008; 25: 1383–93.
6. Quinn KP, Dong L, Golder FJ, Winkelstein BA. Neuronal hyperexcitability in the dorsal horn after painful facet joint injury. Pain 2010; 151: 414–21.
7. Sagar DR, Staniaszek LE, Okine BN et al. Tonic modulation of spinal hyperexcitability by the endocannabinoid receptor system in a rat model of osteoarthritis pain. Arthritis Rheum 2010; 62: 3666–76.
8. Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science 2000; 288: 1765–9.
9. Walker AK, Kavelaars A, Heijnen CJ, Dantzer R. Neuroinflammation and comorbidity of pain and depression. Pharmacol Rev 2014; 66 (1): 80–101.
10. Ji RR, Berta T, Nedergaard M. Glia and pain: is chronic pain a gliopathy? Pain 2013;154 (Suppl. 1): s10-s28.
11. Davydov OS. Perifericheskie i tsentralnye mekhanizmy perekhoda ostroi boli v khronicheskuiu i vozmozhnaia rol ingibirovaniia tsiklooksigenazy 2 v predotvrashchenii khronizatsii bolevogo sindroma. Nevrologiia, neiropsikhiatriia, psikhosomatika. 2016; 8 (2): 10–6. [in Russian]
12. Staal JB, de Bie RA, de Vet HC et al. Injection therapy for subacute and chronic low back pain: an updated Cochrane review. Spine (Phila Pa 1976) 2009; 34 (1): 49–9. DOI: 10.1097/BRS.0b013e3181909558
13. Roelofs PD, Deyo RA, Koes BW et al. Non-steroidal anti-inflammatory drugs for low back pain. Cochrane Database Syst Rev 2008; 1: CD000396.
14. Bjarnason I. Effects of nimesulide and naproxen on the human gastrointestinal tract: a double-blind, crossover study. Rheumatology 1999; 38 (Suppl. 1): 24–32.
15. Bjarnason I, Thjodleifsson B. Gastrointestinal toxicity of non-steroidal anti-nflammatory drugs: the effect of nimesulide compared with naproxen on the human gastrointestinal tract. Rheumatology (Oxford) 1999; 38 (Suppl. 1): 24–32.
16. Marbet GA, Yasikoff Strub ML, Maccioccbi A et al. The effect of nimesulide versus placebo on hemostasis in healthy volunteers. Eur J Clin Pharmacol 1998; 54: 383–7.
17. Rainsford KD. Relationship of nimesulide safety to its pharmacokinetics: assessment of adverse reactions. Rheumatology (Oxford) 1999; 38 (Suppl. 1): 4–10.
18. Rainsford KD. Nimesulide – a multifactorial approach to inflammation and pain: scientific and clinical consensus. Curr Med Res Opin 2006; 22 (6): 1161–70.
19. Brandt KD. Effect of nonsteroidal anti-inflammatory drugs on chondrocyte metabolism in vitro and in vivo. Am J Med 1987; 83: 29–34.
20. Barracchini A, Franceschini N, Amicosante G et al. Can Non-steroidal Anti-inflammatory Drugs Act as Metalloproteinase Modulators? An In vitro Study of inhibition of Collagenase Activity. J Pharm Pharmacol 1998; 50: 1417–23.
21. Pelletier JP, Martel-Pelietier J. Effects of Nimesulide and Naproxen on the Degradation and Metalloprotease Synthesis of Human Osteoarthritic Cartiiaqe. Drugs 1993; 46 (Suppl. 1): 34–9.
22. Kullich WC, Niksic F, Clein G. Effect of nimesulide on metalloproteinases and matrix degradation in osteoarthritis: A pilot clinical study. IJCP Supplement 128 July 2002; p. 4–29.
23. Mayer J, Mooney V, Dagenais S. Evidence-informed management of chronic low back pain with lumbar extensor strengthening exercises. Spine J 2008; 8 (1): 96–113.
Авторы
О.В.Воробьева
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
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O.V.Vorob’eva
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
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