В материале представлены 2 клинических случая заболеваний опорно-двигательного аппарата, сопровождающиеся болевым синдромом. Рассмотрены подходы к терапии с позиций современных данных о патофизиологии болевого синдрома при этих заболеваниях. Показаны механизмы действия и эффекты биорегуляционных препаратов.
Ключевые слова: заболевания опорно-двигательного аппарата, болевой синдром, биорегуляционная медицина, Траумель С, Цель Т, Дискус композитум.
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The material presents 2 clinical cases of diseases of the musculoskeletal system, accompanied by pain syndrome. Approaches to therapy are considered from the perspective of modern data on the pathophysiology of pain syndrome in these diseases. The mechanisms of action and effects of bioregulatory medications are shown.
Key words: diseases of the musculoskeletal system, pain syndrome, bioregulatory medicine, Traumeel S, ZeeL T, Discus compositum.
1. Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ 2003; 81 (9): 646–56. Available at: /pmc/articles/PMC2572542/?report=abstract.
2. Brooks P. Issues with chronic musculoskeletal pain. Rheumatology (Oxford). 2005; 44 (7): 831–3. DOI:10.1093/rheumatology/keh648
3. Connelly LB, Woolf A, Brooks P. Cost-Efectiveness of Interventions for Musculoskeletal Conditions. 2006. Available at: http://www.ncbi.nlm.nih.gov/books/NBK11713/
4. Oren O, Ablin J. Precision medicine: the emerging approach to the chronic pain patient. Int J Clin Rheumtol 2013; 8 (4): 491–9. DOI:10.2217/ijr.13.34
5. Cimmino MA, Ferrone C, Cutolo M. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol 2011; 25 (2): 173–83. DOI:10.1016/j.berh.2010.01.012
6. Van Hecke O, Torrance N, Smith BH. Chronic pain epidemiology and its clinical relevance. Br J Anaesth 2013; 111 (1): 13–8. DOI:10.1093/bja/aet123
7. Practice guidelines for chronic pain management: an updated report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology 2010; 112 (4): 810–33. DOI:10.1097/ALN.0b013e3181c43103
8. Langford RM. Pain management today – what have we learned? Clin Rheumatol 2006; 25 (Suppl. 1): S2–8. DOI:10.1007/s10067-006-0311-5
9. Dieppe P. Chronic musculoskeletal pain. BMJ 2013; 346 (6): f3146. DOI: 10.1136/bmj.f3146
10. Berna C, Leknes S, Holmes EA et al. Induction of depressed mood disrupts emotion regulation neurocircuitry and enhances pain unpleasantness. Biol Psychiatry 2010; 67 (11): 1083–90. DOI:10.1016/j.biopsych.2010.01.014
11. Hall-Flavin DK. Pain and depression: Is there a link? Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/depression/expert-answers/pain-and-depression/faq-2005...
12. Serhan CN, Brain SD, Buckley CD et al. Resolution of inflammation: state of the art, definitions and terms. FASEB J 2007; 21 (2): 325–32. DOI:10.1096/fj.06-7227rev
13. Serhan CN, Petasis NA. Resolvins and protectins in inflammation resolution. Chem Rev 2011; 111 (10): 5922–43. DOI:10.1021/cr100396c
14. Bannenberg GL et al. Molecular Circuits of Resolution: Formation and Actions of Resolvins and Protectins. J Immunol 2005; 174: 4345–55.
15. Ji R-R, Xu Z-Z, Strichartz G, Serhan CN. Emerging roles of resolvins in the resolution of inflammation and pain. Trends Neurosci 2011; 34 (11): 599–609. DOI: 10.1016/j.tins.2011.08.005
16. Schultz GS, Davidson JM et al. Dynamic reciprocity in the wound microenvironment. Wound Repair Regen 2011; 19 (2): 134–48. DOI:10.1111/j.1524-475X.2011.00673.x
17. Xu R, Boudreau A, Bissell MJ. Tissue architecture and function: dynamic reciprocity via extra- and intra-cellular matrices. Cancer Metastasis Rev 2009; 28 (1–2): 167–76. DOI: 10.1007/s10555-008-9178-z
18. Sorokin L. The impact of the extracellular matrix on inflammation. Nat Rev Immunol 2010; 10 (10): 712–23. DOI:10.1038/nri2852
19. Vaday GLO. Extracellular matrix moieties, cytokines, and enzymes: dynamic efects on immune cell behavior and inflammation. J Leukoc Biol 2000; 67: 149–59.
20. Omoigui S. The biochemical origin of pain: the origin of all pain is inflammation and the inflammatory response. Part 2 of 3 – inflammatory profile of pain syndromes. Med Hypotheses 2007; 69 (6): 1169–78. DOI:10.1016/j.mehy.2007.06.033
21. Buttle DJ. Factors controlling matrix turnover in health and disease. Biochem Soc Trans 2007; 35 (Pt 4): 643–6. DOI:10.1042/BST0350643
22. Carnes D, Homer K, Underwood M et al. Pain management for chronic musculoskeletal conditions: the development of an evidence-based and theory-informed pain self-management course. BMJ Open 2013; 3 (11): e003534. DOI:10.1136/bmjopen-2013-003534
23. Ricciotti E, FitzGerald GA. Prostaglandins and inflammation. Arterioscler Thromb Vasc Biol 2011; 31 (5): 986–1000. DOI:10.1161/ATVBAHA.110.207449
24. Clark JD. The pitfalls of profoundly efective analgesic therapies. Clin J Pain 2008; 24 (9): 825–31. DOI:10.1097/AJP.0b013e3181773b7f
25. Woolf CJ. Review series introduction What is this thing called pain? 2010; 120 (11). DOI:10.1172/JCI45178.3742.
26. Al RG et al. Efectiveness of Heel Products in Treating Neurosis-Like Disorders in Osteochondrosis of the Cervical Spine. Biol Med 1997; 2: 47–52.
27. Reckeweg HH. Homotoxikologie: Ganzheitsschau einer Synthese der Medizin. Baden-Baden, Germany: Aurelia, 1975.
28. Biotherapeutic Index A Medical Compendium for Health Care Professionals. 2012.
29. Csermely PVÁ, Pongor S. The eiciency of multi-target drugs: the network approach might help drug design. TRENDS Pharmacol Sci 2005; 26: 178–82.
30. Schneider C. Traumeel – an emerging option to nonsteroidal anti-inflammatory drugs in the management of acute musculoskeletal injuries. Int J Gen Med 2011; 4: 225–34. DOI: 10.2147/IJGMS16709.
31. Schneider C, Schneider B, Hanisch J, van Haselen R. The role of a homoeopathic preparation compared with conventional therapy in the treatment of injuries: an observational cohort study. Complement Ther Med 2008; 16 (1): 22–7. DOI: 10.1016/j.ctim.2007.04.004
32. Wagner H. Multitarget therapy – The future of treatment for more than just functional dyspepsia. Phytomedicine 2006; 13: 122–9.
33. González de Vega C, Speed C, Wolfarth B, González J. Traumeel vs. diclofenac for reducing pain and improving ankle mobility after acute ankle sprain: a multicentre, randomised, blinded, controlled and non-inferiority trial. Int J Clin Pract 2013; 67 (10): 979–89. DOI: 10.1111/ijcp.12219
34. Wodick RE, Steininger KZS. The biological treatment of articular afections – results of a study conducted with 498 patients. Biol Medizin 1993; 3: 127–35.
35. Zenner S. Application possibilities of Traumeel® S injection solution: results of a multicentric drug monitoring trial conducted on 3,241 patients. Biol Ther 1992; 10 (4): 301–10.
36. Zell J, Connert WD, Mau J. Behandlung von akuten Sprunggelenksdistorsionen: Doppelblindstudie zum Wirksamkeitsnachweis eines homöopathischen Salbenpräparats. Fortschr Med 1988; 106 (5): 96–100.
37. Schneider C, Schneider B, Hanisch J van HR. The role of a homeopathic preparation compared with conventional therapy in the treatment of injuries: an observational cohort study. Complement Ther Med 2008; 16 (1): 22–7.
38. Dakin SG, Dudhia J, Smith RKW. Resolving an inflammatory concept: The importance of inflammation and resolution in tendinopathy. Vet Immunol Immunopathol. 2014; 158 (3–4): 121–7. DOI:10.1016/j.vetimm.2014.01.007
39. Butterfield TA, Best TM, Merrick MA. The dual roles of neutrophils and macrophages in inflammation: a critical balance between tissue damage and repair. J Athl Train 2006; 41 (4): 457–65. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1748424&tool=pmcentrez&rendertype=abstract
40. Van Hecke O, Torrance N, Smith BH. Chronic pain epidemiologywhere do lifestyle factors fit in? Br J Pain 2013; 7 (4): 209–217. DOI:10.1177/2049463713493264
41. Dubois MY, Gallagher RM, Lippe PM. Pain medicine position paper. Pain Med 2009; 10 (6): 972–1000. DOI:10.1111/j.1526-4637.2009.00696.x.
42. Jäggi R, Würgler U, Grandjean F, Weiser M. Dual inhibition of 5-lipoxygenase/cyclooxygenase by a reconstituted homeopathic remedy; possible explanation for clinical eicacy and favourable gastrointestinal tolerability. Inflamm Res 2004; 53 (4): 150–7. DOI:10.1007/s00011-003-1236-y
________________________________________________
1. Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ 2003; 81 (9): 646–56. Available at: /pmc/articles/PMC2572542/?report=abstract.
2. Brooks P. Issues with chronic musculoskeletal pain. Rheumatology (Oxford). 2005; 44 (7): 831–3. DOI:10.1093/rheumatology/keh648
3. Connelly LB, Woolf A, Brooks P. Cost-Efectiveness of Interventions for Musculoskeletal Conditions. 2006. Available at: http://www.ncbi.nlm.nih.gov/books/NBK11713/
4. Oren O, Ablin J. Precision medicine: the emerging approach to the chronic pain patient. Int J Clin Rheumtol 2013; 8 (4): 491–9. DOI:10.2217/ijr.13.34
5. Cimmino MA, Ferrone C, Cutolo M. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol 2011; 25 (2): 173–83. DOI:10.1016/j.berh.2010.01.012
6. Van Hecke O, Torrance N, Smith BH. Chronic pain epidemiology and its clinical relevance. Br J Anaesth 2013; 111 (1): 13–8. DOI:10.1093/bja/aet123
7. Practice guidelines for chronic pain management: an updated report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology 2010; 112 (4): 810–33. DOI:10.1097/ALN.0b013e3181c43103
8. Langford RM. Pain management today – what have we learned? Clin Rheumatol 2006; 25 (Suppl. 1): S2–8. DOI:10.1007/s10067-006-0311-5
9. Dieppe P. Chronic musculoskeletal pain. BMJ 2013; 346 (6): f3146. DOI: 10.1136/bmj.f3146
10. Berna C, Leknes S, Holmes EA et al. Induction of depressed mood disrupts emotion regulation neurocircuitry and enhances pain unpleasantness. Biol Psychiatry 2010; 67 (11): 1083–90. DOI:10.1016/j.biopsych.2010.01.014
11. Hall-Flavin DK. Pain and depression: Is there a link? Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/depression/expert-answers/pain-and-depression/faq-2005...
12. Serhan CN, Brain SD, Buckley CD et al. Resolution of inflammation: state of the art, definitions and terms. FASEB J 2007; 21 (2): 325–32. DOI:10.1096/fj.06-7227rev
13. Serhan CN, Petasis NA. Resolvins and protectins in inflammation resolution. Chem Rev 2011; 111 (10): 5922–43. DOI:10.1021/cr100396c
14. Bannenberg GL et al. Molecular Circuits of Resolution: Formation and Actions of Resolvins and Protectins. J Immunol 2005; 174: 4345–55.
15. Ji R-R, Xu Z-Z, Strichartz G, Serhan CN. Emerging roles of resolvins in the resolution of inflammation and pain. Trends Neurosci 2011; 34 (11): 599–609. DOI: 10.1016/j.tins.2011.08.005
16. Schultz GS, Davidson JM et al. Dynamic reciprocity in the wound microenvironment. Wound Repair Regen 2011; 19 (2): 134–48. DOI:10.1111/j.1524-475X.2011.00673.x
17. Xu R, Boudreau A, Bissell MJ. Tissue architecture and function: dynamic reciprocity via extra- and intra-cellular matrices. Cancer Metastasis Rev 2009; 28 (1–2): 167–76. DOI: 10.1007/s10555-008-9178-z
18. Sorokin L. The impact of the extracellular matrix on inflammation. Nat Rev Immunol 2010; 10 (10): 712–23. DOI:10.1038/nri2852
19. Vaday GLO. Extracellular matrix moieties, cytokines, and enzymes: dynamic efects on immune cell behavior and inflammation. J Leukoc Biol 2000; 67: 149–59.
20. Omoigui S. The biochemical origin of pain: the origin of all pain is inflammation and the inflammatory response. Part 2 of 3 – inflammatory profile of pain syndromes. Med Hypotheses 2007; 69 (6): 1169–78. DOI:10.1016/j.mehy.2007.06.033
21. Buttle DJ. Factors controlling matrix turnover in health and disease. Biochem Soc Trans 2007; 35 (Pt 4): 643–6. DOI:10.1042/BST0350643
22. Carnes D, Homer K, Underwood M et al. Pain management for chronic musculoskeletal conditions: the development of an evidence-based and theory-informed pain self-management course. BMJ Open 2013; 3 (11): e003534. DOI:10.1136/bmjopen-2013-003534
23. Ricciotti E, FitzGerald GA. Prostaglandins and inflammation. Arterioscler Thromb Vasc Biol 2011; 31 (5): 986–1000. DOI:10.1161/ATVBAHA.110.207449
24. Clark JD. The pitfalls of profoundly efective analgesic therapies. Clin J Pain 2008; 24 (9): 825–31. DOI:10.1097/AJP.0b013e3181773b7f
25. Woolf CJ. Review series introduction What is this thing called pain? 2010; 120 (11). DOI:10.1172/JCI45178.3742.
26. Al RG et al. Efectiveness of Heel Products in Treating Neurosis-Like Disorders in Osteochondrosis of the Cervical Spine. Biol Med 1997; 2: 47–52.
27. Reckeweg HH. Homotoxikologie: Ganzheitsschau einer Synthese der Medizin. Baden-Baden, Germany: Aurelia, 1975.
28. Biotherapeutic Index A Medical Compendium for Health Care Professionals. 2012.
29. Csermely PVÁ, Pongor S. The eiciency of multi-target drugs: the network approach might help drug design. TRENDS Pharmacol Sci 2005; 26: 178–82.
30. Schneider C. Traumeel – an emerging option to nonsteroidal anti-inflammatory drugs in the management of acute musculoskeletal injuries. Int J Gen Med 2011; 4: 225–34. DOI: 10.2147/IJGMS16709.
31. Schneider C, Schneider B, Hanisch J, van Haselen R. The role of a homoeopathic preparation compared with conventional therapy in the treatment of injuries: an observational cohort study. Complement Ther Med 2008; 16 (1): 22–7. DOI: 10.1016/j.ctim.2007.04.004
32. Wagner H. Multitarget therapy – The future of treatment for more than just functional dyspepsia. Phytomedicine 2006; 13: 122–9.
33. González de Vega C, Speed C, Wolfarth B, González J. Traumeel vs. diclofenac for reducing pain and improving ankle mobility after acute ankle sprain: a multicentre, randomised, blinded, controlled and non-inferiority trial. Int J Clin Pract 2013; 67 (10): 979–89. DOI: 10.1111/ijcp.12219
34. Wodick RE, Steininger KZS. The biological treatment of articular afections – results of a study conducted with 498 patients. Biol Medizin 1993; 3: 127–35.
35. Zenner S. Application possibilities of Traumeel® S injection solution: results of a multicentric drug monitoring trial conducted on 3,241 patients. Biol Ther 1992; 10 (4): 301–10.
36. Zell J, Connert WD, Mau J. Behandlung von akuten Sprunggelenksdistorsionen: Doppelblindstudie zum Wirksamkeitsnachweis eines homöopathischen Salbenpräparats. Fortschr Med 1988; 106 (5): 96–100.
37. Schneider C, Schneider B, Hanisch J van HR. The role of a homeopathic preparation compared with conventional therapy in the treatment of injuries: an observational cohort study. Complement Ther Med 2008; 16 (1): 22–7.
38. Dakin SG, Dudhia J, Smith RKW. Resolving an inflammatory concept: The importance of inflammation and resolution in tendinopathy. Vet Immunol Immunopathol. 2014; 158 (3–4): 121–7. DOI:10.1016/j.vetimm.2014.01.007
39. Butterfield TA, Best TM, Merrick MA. The dual roles of neutrophils and macrophages in inflammation: a critical balance between tissue damage and repair. J Athl Train 2006; 41 (4): 457–65. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1748424&tool=pmcentrez&rendertype=abstract
40. Van Hecke O, Torrance N, Smith BH. Chronic pain epidemiologywhere do lifestyle factors fit in? Br J Pain 2013; 7 (4): 209–217. DOI:10.1177/2049463713493264
41. Dubois MY, Gallagher RM, Lippe PM. Pain medicine position paper. Pain Med 2009; 10 (6): 972–1000. DOI:10.1111/j.1526-4637.2009.00696.x.
42. Jäggi R, Würgler U, Grandjean F, Weiser M. Dual inhibition of 5-lipoxygenase/cyclooxygenase by a reconstituted homeopathic remedy; possible explanation for clinical eicacy and favourable gastrointestinal tolerability. Inflamm Res 2004; 53 (4): 150–7. DOI:10.1007/s00011-003-1236-y