medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2024-12-15-19medalphabet-3816Research ArticleСтатьиМультидисциплинарные возможности коррекции хронического неспецифического болевого синдрома нижней части спины (обзор литературы)Multidisciplinary options for the correction of chronic nonspecific low back pain syndrome (literature review)https://orcid.org/0000-0002-9238-8270СороковиковаТ. В.SorokovikovaT. V.

Сороковикова Татьяна Викторовна, к. м. н., доцент кафедры неврологии, реабилитации и нейрохирургии

Тверь

Sorokovikova Tatiana V., PhD Med, associate professor at Dept of Neurology, Rehabilitation and Neurosurgery

Tver

МеньшиковаТ. В.MenshikovaT. V.

Меньшикова Татьяна Викторовна, к. м. н., доцент кафедры неврологии, реабилитации и нейрохирургии

Тверь

Menshikova Tatiana V., PhD Med, associate professor at Dept of Neurology, Rehabilitation and Neurosurgery

Tver

https://orcid.org/0000-0003-4213-5379МорозовА. М.MorozovA. M.

Морозов Артем Михайлович, к. м. н., доцент кафедры общей хирургии

Тверь

Morozov Artem M., PhD Med, associate professor at Dept of General Surgery

Tver

ammorozovv@gmail.comhttps://orcid.org/0009-0007-5289-6856КрюковаА. Н.KryukovaA. N.

Крюкова Анастасия Николаевна, студентка 5 курса лечебного факультета

Тверь

Kryukova Anastasia N., 5th year student at Faculty of Medicine

Tver

ФГБОУ ВО «Тверской государственный медицинский университет» Минздрава РоссииРоссияTver State Medical UniversityRussian Federation202412082024012Неврология и психиатрия (2)1519Copyright © Сороковикова Т.В., Меньшикова Т.В., Морозов А.М., Крюкова А.Н., 20242024Сороковикова Т.В., Меньшикова Т.В., Морозов А.М., Крюкова А.Н.Sorokovikova T.V., Menshikova T.V., Morozov A.M., Kryukova A.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/3816

Хроническая боль в спине – жалоба, с которой пациенты наиболее часто обращаются за медицинской помощью к терапевтам, неврологам, хирургам, травматологам и другим узким специалистам. Боль в нижней части спины может носить либо неспецифический характер, то есть не иметь конкретной нозологической причины, либо быть специфической, то есть иметь определенный патофизиологический механизм возникновения, обусловленный как спинальными, так и внеспинальными причинами. Данный факт обуславливает важность комплексной и многопрофильной оценки характеристик хронического болевого синдром нижней части спины.Целью настоящего исследования является изучение возможности реализации мультидисциплинарного подхода в лечении неспецифического болевого синдрома нижней части спины.Результаты. Боль области нижней части спины – боль, которая локализуется между двенадцатой парой ребер и ягодичными складками. Установить источник боли при неспецифическом ее характере не всегда возможно, более того, нет убедительных доказательств, что уточнение локализации благоприятно повлияет на течение и исход заболевания. Выделяют три основные причины неспецифической боли нижней части спины: миофасциальный синдром; патология суставов и связочного аппарата позвоночника и поясничный остеохондроз, который представляет собой естественный процесс дегенерации структур позвоночника и наблюдается в разной степени у всех людей, существенно нарастая с возрастом. Считается, что болевой синдром области спины обладает многогранной патофизиологией, на которую влияют соматическая патология, психологические и социальные факторы. Это объясняет необходимость комплексного многостороннего подхода к конкретному пациенту и составления индивидуальной программы лечения, реабилитации и профилактики последующих обострений. Мультидисциплинарный подход означает комплексную скоординированную параллельную работу специалистов, направленную на решение проблемы хронической боли.Заключение. Мультидисциплинарный подход к лечению пациентов с хроническим неспецифическим болевым синдромом нижней части спины является более эффективным, по отношению к монотерапии, поскольку учитывает индивидуальные особенности клинической симптоматики, позволяет проводить лечение и реабилитацию по индивидуальному плану, включающему комплекс взаимосвязанных мероприятий, направленных на улучшение качества жизни пациента и его функциональных возможностей.

Chronic back pain is the complaint with which patients most often seek medical help from general practitioners, neurologists, surgeons, traumatologists and other subspecialists. Pain in the lower back can be either nonspecific, i. e., have no specific nosologic cause, or be specific, i. e., have a certain pathophysiologic mechanism of occurrence due to both spinal and extra-spinal causes. This fact determines the importance of complex and multidisciplinary assessment of the characteristics of chronic low back pain syndrome.The aim of the present study was to investigate the possibility of realizing a multidisciplinary approach in the treatment of nonspecific low back pain syndrome.Results. Low back pain is pain that is localized between the twelfth pair of ribs and the gluteal folds. It is not always possible to determine the source of pain when it is nonspecific; moreover, there is no convincing evidence that clarification of localization will favorably affect the course and outcome of the disease. There are three main causes of nonspecific low back pain: myofascial syndrome; pathology of joints and ligamentous apparatus of the spine; and lumbar osteochondrosis, which is a natural process of degeneration of spinal structures and is observed to varying degrees in all people, increasing significantly with age. It is believed that the pain syndrome of the back region has a multifaceted pathophysiology, which is influenced by somatic pathology, psychological and social factors. This explains the need for an integrated multidisciplinary approach to a particular patient and the compilation of an individual program of treatment, rehabilitation and prevention of subsequent exacerbations. Multidisciplinary approach means complex coordinated parallel work of specialists aimed at solving the problem of chronic pain.Conclusion. Multidisciplinary approach to the treatment of patients with chronic nonspecific low back pain syndrome is more effective than monotherapy, because it takes into account individual features of clinical symptoms, allows to carry out treatment and rehabilitation according to an individual plan, including a set of interrelated measures aimed at improving the quality of life of the patient and his functional capabilities.

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The authors declare that there are no conflicts of interest present.