The paper presents the results of the Osteoarthritis (OA) Expert Council held on September 8, 2019, which was attended by Russian and foreign specialists. The experts considered pharmacological treatment options for OA. The expert meeting resolution states that the treatment of patients with OA should be based on an individual assessment of the patient and on a modern evidence base of therapy efficacy.Treatment of patients with OA is based on the principles of evidence-based medicine that requires an integrated approach and the need of SYSADOAs prescription. Combined drugs with therapeutic dosages of chondroitin sulfate and glucosamine in the early stages of the disease are available as basic agents. The place of paracetamol in the anesthetic therapy algorithm in OA needs to be clarified. It is also noted that when choosing nonsteroidal anti-inflammatory drugs for OA treatment, it is important to take into account individual patient characteristics and the presence of comorbidities.

In 2015, the experts from various medical associations of Russia elaborated the clinical guidelines “Rational use of nonsteroidal anti-inflammatory drugs (NSAIDs) in clinical practice”. These guidelines were drawn up to improve the use of NSAIDs, our country’s most popular agents to treat pain in acute and chronic diseases. The main purpose of this paper was to reduce the frequency of potentially dangerous class-specific adverse events (AE) that may arise from the use of NSAIDs. To do this, the authors proposed a NSAID choice algorithm based on the assessment of risk factors for AE, the individual characteristics of various representatives of this drug group, and the possibility of prevention of AE.Since then, new data on the efficacy and safety of NSAIDs have been obtained. This has necessitated the revision and addition of a number of provisions in the 2015 guidelines. It seems that the new version of the guidelines, which has been drawn up based on the analysis of a large number of clinical and epidemiological studies, their meta-analysis, by taking into account the clinical experience and opinion of the world’s leading experts, presents more fully the main aspects of the use of NSAIDs in real clinical practice.The guidelines are intended for physicians of all specialties.

The main manifestation of joint and spine diseases, such as osteoarthritis, nonspecific back pain, and soft tissue rheumatic disorders, is musculoskeletal pain (MSP). It leads to considerable morbidity as well as temporary and permanent disability in millions of people of our country. These people need adequate medical care and most significantly a prompt and maximally complete analgesia. Unfortunately, serious problems are being faced in this field of medicine. The lack of a unified approach or continuity in the therapeutic process, inadequate knowledge of the pathogenesis of MSP and of the possibilities of its therapy may substantially hamper the work of practitioners.The meeting of Russian experts who were represented in different medical specialties and discussed the optimization of MSP treatment policy was held in Moscow on 20 June 2015. According to the results of the meeting, the authors identified the main points regarding the theoretical and practical aspects of MSP and also proposed an algorithm for the treatment of this pathology. It seems that the use of this algorithm will be able to facilitate the work of practitioners and to enhance the efficiency and safety of analgesic therapy.

The main manifestation of joint and spine diseases, such as osteoarthritis, nonspecific back pain, and soft tissue rheumatic disorders, is musculoskeletal pain (MSP). It leads to considerable morbidity as well as temporary and permanent disability in millions of people of our country. These people need adequate medical care and most significantly a prompt and maximally complete analgesia. Unfortunately, serious problems are being faced in this field of medicine. The lack of a unified approach or continuity in the therapeutic process, inadequate knowledge of the pathogenesis of MSP and of the possibilities of its therapy may substantially hamper the work of practitioners. The meeting of Russian experts who were represented in different medical specialties and discussed the optimization of MSP treatment policy was held in Moscow on 20 June 2015. According to the results of the meeting, the authors identified the main points regarding the theoretical and practical aspects of MSP and also proposed an algorithm for the treatment of this pathology. It seems that the use of this algorithm will be able to facilitate the work of practitioners and to enhance the efficiency and safety of analgesic therapy.

We have analyzed the causes of late admission of the patients with rotator cuff injuries (RCI). 29.2% of the patients didn’t seek medical attention in the timely manner, and the diagnosis was made incorrectly in 27.5% of cases. Based on 120 cases, a diagnostic algorithm for the rotator cuff injuries had been developed allowing to put a correct diagnosis in the early stages.

The paper presents the new version of the clinical guidelines «Rational use of nonsteroidal anti-inflammatory drugs (NSAIDs) in clinical practice » prepared by the Association of Rheumatologists of Russia, the Russian Pain Society, the Russian Gastroenterological Association, the Russian Society of Cardiology, the Association of Traumatologists and Orthopedists of Russia, the Association of Interdisciplinary Medicine, and the Russian Association of Palliative Medicine. In our country, NSAIDs are the most important and most popular class of analgesics. Unlike global practice, Russian physicians rather rarely recommend paracetamol as a first-line drug to relieve moderate or severe pain, by giving preference to NSAIDs; the use of opioid analgesics for noncancers is minimized because of tight legal restrictions. NSAIDs are effective and easy-to-use; however, they are far from safe; the administration of these medications may lead to serious gastrointestinal, cardiovascular, renal, and other complications in a number of cases. So the use of NSAIDs should be compulsorily monitored for adverse reactions and the choice of a specific drug for each clinical case should be based on the objective estimation of a ratio of its efficacy to safety. In recent years, there have been fresh data on the use of NSAIDs for different diseases and a few novel representatives of this drug group have appeared on the Russian pharmacological market. This all has necessitated a new version of the guidelines on the rational use of NSAIDs. These are based on the provisions that have high validity and have been confirmed by the results of well-organized clinical and large-scale population-based studies, as well as by their meta-analysis. The guidelines are intended for physicians of all specialties.