mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2022-5-94-100mrj-1353Research ArticleОБЗОРЫREVIEWSХроническая боль в спине глазами ревматологаChronic back pain from rheumatologist point of viewhttps://orcid.org/0000-0002-8665-7980ОлюнинЮ. А.OlyuninYu. A.

Юрий Александрович Олюнин

115522, Москва, Каширское шоссе, 34А

Yury A. Olyunin

34A, Kashirskoe Shosse, Moscow 115522

olyunin@mail.ruhttps://orcid.org/0000-0002-6068-3080ЛилаА. М.LilaA. M.

Кафедра ревматологии ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России

115522, Москва, Каширское шоссе, 34А,

125993, Москва, ул. Баррикадная, 2/1, стр. 1

Department of Rheumatology Russian Medical Academy of Continuing Professional Education

34A, Kashirskoe Shosse, Moscow 115522,

2/1, Barrikadnaya Street, Build. 1, Moscow 125993

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияV.A. Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuing Professional EducationRussian Federation20221910202216594100Copyright © Олюнин Ю.А., Лила А.М., 20222022Олюнин Ю.А., Лила А.М.Olyunin Y.A., Lila A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/1353

Боль в спине может быть обусловлена разными этиологическими факторами, а ее развитие опосредовано разными патогенетическими механизмами. К анатомическим структурам, способным участвовать в формировании болевого синдрома, относятся мышцы, фасции, связки, сухожилия, фасеточные суставы, межпозвоночные диски и позвонки. Важной причиной развития хронической боли в нижней части спины (БНЧС) являются изменения, возникающие в центральной системе модуляции боли. Накапливаются данные, позволяющие рассматривать БНЧС не как серию изолированных, не связанных между собой эпизодов, а как продолжительное состояние с вариабельным течением. В практике ревматолога БНЧС может встречаться как проявление основного заболевания или как коморбидная патология на фоне ревматической патологии. В этом случае могут возникать затруднения при определении активности основного заболевания и эффективности проводимой терапии.

Back pain can be caused by various etiological factors, and its development is mediated by various pathogenetic mechanisms. Anatomical structures that can participate in the formation of pain include muscles, fascia, ligaments, tendons, facet joints, intervertebral discs and vertebrae. Changes in the central pain modulation system are an important factor in the development of chronic low back pain (LBP). Accumulating evidence allows us to consider LBP not as a series of isolated unrelated episodes, but as a long-term condition with a variable course. In the practice of a rheumatologist, LBP can occur as a manifestation of the underlying disease or as a comorbid pathology on the background of rheumatic pathology. In this case, it may be difficult to determine the activity of the underlying disease and the effectiveness of the therapy.

ревматические заболеванияхроническая боль в спинецентральная сенситизацияревматоидный артритноцицептивная больлечениеrheumatic diseaseschronic back paincentral sensitizationrheumatoid arthritisnociceptive paintreatmentСтатья спонсируется компанией «STADA»This article has been supported by STADAReferencesGBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018 Nov 10;392(10159):1789-858. doi: 10.1016/S0140-6736(18)32279-7.GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. 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The authors declare that there are no conflicts of interest present.