Pain syndrome is one of the most common reasons to seek medical help. The paper considers an issue of pain syndrome in patients with various diseases. Various pathogenetic variants of dorsalgia development in the setting of inflammatory and degenerative-dystrophic changes are presented. The main biomechanical and biochemical processes associated with the pain syndrome are summarized. Several features of the course and therapeutic methods of the back pain syndrome associated with ankylosing spondylitis, osteoarthritis, as well as gouty and rheumatoid arthritis are considered. The paper outlines general principles of therapy for acute and chronic nociceptive pain syndromes. Medicinal and non-medicinal therapeutic methods are discussed. Since specific and non-specific inflammatory reactions represent a key pathogenetic mechanism in most of the reviewed cases of acute and chronic pain syndrome, anti-inflammatory drugs play a leading role in the condition therapy. We considered the possibility to use nonsteroidal anti-inflammatory drugs (NSAIDs) and B vitamins. KEYWORDS: back pain, osteoarthritis, ankylosing spondylitis, rheumatoid arthritis, chronic pain syndrome, acute pain syndrome. FOR CITATION: Barulin А.Е., Kurushina O.V., Puchkov A.E. Clinical aspects of management of patients with acute and chronic pain. Russian Medical Inquiry. 2024;8(10):576–581 (in Russ.). DOI: 10.32364/2587-6821-2024-8-10-5

Spinal pain syndromes come to the forefront in the structure of referral rates for medical advice and considerably reduce quality of life in this category of patients. The paper considers the role of an edematous component in the development and chronization of pain. Occurring edema gives rise to local hemo- and lymphodynamic disorders, dysregulated vascular tone, activated thrombogenesis, and increased vascular permeability, eventually leading to the excessive irritation of nociceptors, the enhancement of a pain component, and the progression of tissue swelling. Objective: to study the efficacy of L-lysine escinate in the combination treatment of acute non-specific low back pain. Patients and methods. Sixty-two patients aged 21 to 53 patients (mean age 36.4±0.9 years) with acute low back pain were examined. L-lysine escinate having venotonic and anti-inflammatory activities was chosen as an agent to correct edema syndrome. The results of clinical, neurological, and manual muscular testing and assessment of the biomechanics of the vertebral column, obtained using the original soft package “Visual optic analysis” developed by the authors, were analyzed. All the patients were found to have acute non-specific low back pain or radiculopathy (entrapment syndrome) and considerable changes in the biomechanics of the vertebral column. The patients were treated in accordance with the standards of medical care for spinal pain. L-lysine escinate was additionally incorporated as an antiedema drug into the therapeutic complex of the patients in the study group. Results and discussion. The study patient group demonstrated a more pronounced trend towards reductions in pain syndrome and local muscle edema. It was noted that L-lysine escinate was effective in treating both acute pain syndromes and exacerbations of chronic low back pain and that additional non-drug programs should be included in order to correct an impaired motor stereotype.

Spinal pain syndromes come to the forefront in the structure of referral rates for medical advice and considerably reduce quality of life in this category of patients. The paper considers the role of an edematous component in the development and chronization of pain. Occurring edema gives rise to local hemo- and lymphodynamic disorders, dysregulated vascular tone, activated thrombogenesis, and increased vascular permeability, eventually leading to the excessive irritation of nociceptors, the enhancement of a pain component, and the progression of tissue swelling.Objective: to study the efficacy of L-lysine escinate in the combination treatment of acute non-specific low back pain.Patients and methods. Sixty-two patients aged 21 to 53 patients (mean age 36.4±0.9 years) with acute low back pain were examined. L-lysine escinate having venotonic and anti-inflammatory activities was chosen as an agent to correct edema syndrome. The results of clinical, neurological, and manual muscular testing and assessment of the biomechanics of the vertebral column, obtained using the original soft package “Visual optic analysis” developed by the authors, were analyzed. All the patients were found to have acute non-specific low back pain or radiculopathy (entrapment syndrome) and considerable changes in the biomechanics of the vertebral column. The patients were treated in accordance with the standards of medical care for spinal pain. L-lysine escinate was additionally incorporated as an antiedema drug into the therapeuticcomplex of the patients in the study group.Results and discussion. The study patient group demonstrated a more pronounced trend towards reductions in pain syndrome and local muscle edema. It was noted that L-lysine escinate was effective in treating both acute pain syndromes and exacerbations of chronic low back pain and that additional non-drug programs should be included in order to correct an impaired motor stereotype.

Vertebral basilar insufficiency is a multidisciplinary problem. The lecture discusses current approaches to diagnosis and treatment of acute and chronic insufficiency of vertebral basilar system.

Modern views are presented in article on a vertebral artery syndrome, mechanisms of its formation, clinical and diagnostics features. Main types of pharmacological and non-pharmacological treatment are given.