mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2011-669mrj-354Research ArticleСтатьиArticlesНеспецифическая боль в пояснично-крестцовой области: клинические особенностии подходы к медикаментозной терапии (по материалам европейских рекомендацийпо лечению неспецифической боли в пояснично-крестцовой области)Nonspecific pain in the lumbosacral area: clinical features of and approachesto drug therapy (according to the materials of the European guidelinesfor the management of nonspecific lumbosacral pain)РаскинаТатьяна АлексеевнаRaskinaTat'yana Alekseevnarassib@mail.ruКоролеваМ. В.KorolevaM V-РаскинаТатьяна АлексеевнаRaskinaTatyana Alekseyevnarassib@mail.ruКоролеваМ. В.KorolevaM V-20111406201152№2 (2011)5055Copyright © Раскина Т.А., Королева М.В., Раскина Т.А., Королева М.В., 20112011Раскина Т.А., Королева М.В., Раскина Т.А., Королева М.В.Raskina T.A., Koroleva M.V., Raskina T.A., Koroleva M.V.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/354

Представлены особенности клинической картины, диагностики и лечения болевого синдрома в пояснично-крестцовой области.

The paper describes the .specific features of the clinical presentation, diagnosis, and treatment of pain syndrome in the lumbosacral area.

боль в пояснично-крестцовой областианальгетическая терапиясирдалудlumbosacral painanalgesic therapysirdaludReferences<div><p>Airaksinen O., Brox J.I., Cedraschi C. et al. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 2006; 15(2): 192-300.</p><p>Andersson G.B.J. The epidemiology of spinal disorders. In: Frymoyer J.W., ed. The adult spine: principles and practice. 2nd ed. New York: Raven Press, 1997; 93-141.</p><p>Frymoyer J.W. Back pain and sciatica. N Engl J Med 1988; 318: 291-300.</p><p>Royal College of General Practitioners. Clinical Guidelines for the Management of Acute Low Back Pain. London: Royal College of General Practitioners, 1996 and 1999.</p><p>Hoogendoorn W.E., van Poppel M.N.M., Bongers P.M. et al. Systemic review of psychosocial factors at work and private life as risk factors for back pain. Spine 2000; 25: 2114-25.</p><p>Linton S.J. A review of psychological risk factors in back and neck pain. Spine 2000; 25: 1148-56.</p><p>Van Tulder M.W., Assendelft W.J.J., Koes B.W. et al. Spinal radiographic findings and nonspecific low back pain: a systematic review of observational studies. Spine 1997; 22: 427-34.</p><p>Jarvik J.G., Hollingworth W., Martin B. et al. Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial. JAMA 2003; 289: 2810-8.</p><p>Van Tulder M.W., Koes B.W., Bouter L.M. Conservative treatment of acute and chronic nonspecific low back pain: a systematic review of randomized controlled trials of the most common interventions. Spine 1997; 22: 2128-56.</p><p>De Craen A.J.M., Di Giulio G., Lampe- Schoenmaeckers A.J.E.M. et al. Analgesic efficacy and safety of paracetamol-codeine combinations versus paracetamol alone: a systematic review. Br Med J 1996; 313: 321-5.</p><p>Koes B.W., Scholten R.J.P.M., Mens J.M.A. et al. Efficacy of non-steroidal anti-inflammatory drugs for low back pain: a systematic review of randomised clinical trials. Ann Rheum Dis 1997; 56: 214-23.</p><p>Van Tulder M.W., Scholten R.J.P.M., Koes B.W. et al. Non-steroidal anti-inflammatory drugs (NSAIDs) for non-specific low back pain (Cochrane Review). In: The Cochrane Library, Issue 4, Oxford: Update Software 2000.</p><p>Henry D., Lim L.L.Y., Rodriguez L.A.G. et al. Variability in risk of gastrointestinal complications with individual non-steroidal anti-inflammatory drugs: results of a collaborative meta-analysis. Br Med J 1996; 312: 1563-6.</p><p>Van Tulder M.W., Touray T., Furlan A.D. et al. Muscle relaxants for non-specific low back pain (Cochrane Review). In: The Cochrane Library, Issue 1. Chichester, UK: John Wiley &amp; Sons, Ltd, 2004.15.</p><p>Bigos S., Bowyer O., Braen G. et al. Acute low back problems in adults. Clinical practice guideline no. 14. AHCPR publication no. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of health and Human Services. December 1994.</p><p>Van Tulder M., Becker A., Bekkering T. et al. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J 2006; 15(Suppl. 2): 169-91.</p><p>Данилов А.Б. Возможности применения тизанидина (сирдалуда) в клинической практике. Обзор литературы. РМЖ 2009; 17 (20): 1370.</p><p>Coward D.M. Tizanidine: Neuropharmacology and mechanism of action. Neurology 1994; 44(Suppl. 9): 6-11.</p><p>Hutchinson D.R., Daniels F. A multinational study in general practice to evaluate the effectiveness and tolerability of tizanidine in the treatment of painful muscle spasms. Br J Clin Res 1990; 1: 39-48.</p><p>Berry H., Hutchinson D.R. Tizanidine and ibuprofen in acute low-back pain: Results of a double-blind multicentre study in general practice. J Intern Med Res 1988; 16: 83-91.</p><p>Sirdalud Ternilin Asia-Pacific Study group. Efficacy and gastroprotective effects of tizanidine plus diclofenac versus placebo plus diclofenac in patients with painful muscle spasm. Curr Ther Res 1998; 59: 13-22.</p><p>Бадокин В.В. Применение сирдалуда в ревматологической практике. РМЖ 2005; 13(24): 1588-9.</p><p>Bettucci D., Testa L., Calzoni S. et al. Combination of tizanidine and amitriptyline in the prophylaxis of chronic tension - type headache: evaluation of efficacy and impact on quality of life. J Headache Pain 2006; 7(1): 34-6.</p><p>Воробьева О.В. Возможности альфа2- адренергических агонистов в лечении миофасциальной боли. РМЖ 2007; 5: 445-8.</p><p>McCleane G.J. Does Gabapentin have an analgesic effect on background, movement and referred pain? A randomised, doubleblind, placebo controlled study. Pain Clinic 2001; 13: 103-7.</p><p>Keitel W., Frerick H., Kuhn U. et al. Capsicum pain plaster in chronic non-specific low back pain. Arzneimittelforschung 2001; 51(11): 896-903.</p><p>Frerick H., Keitel W., Kuhn U. et al. Topical treatment of chronic low back pain with a capsicum plaster. Pain 2003; 106(1- 2): 59-64.</p><p>Koes B.W., Scholten R.J.P.M., Mens J.M.A. et al. Epidural steroid injections for low back pain and sciatica: an updated systematic review of randomized clinical trials. Pain Digest 1999; 9: 241-7.</p><p>Nelemans P.J., de Bie R.A., de Vet H.C.W. et al. Injection therapy for subacute and chronic benign low back pain. In: The Cochrane Library, Issue 4. Oxford: Update Software, 2001.</p><p>Watts R.W., Silagy C.A. A meta-analysis on the efficacy of epidural corticosteroids in the treatment of sciatica. Anaesth Intensive Care 1995; 23: 564-9.</p></div><br /><div><p>Airaksinen O., Brox J.I., Cedraschi C. et al. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 2006; 15(2): 192-300.</p><p>Andersson G.B.J. The epidemiology of spinal disorders. In: Frymoyer J.W., ed. The adult spine: principles and practice. 2nd ed. New York: Raven Press, 1997; 93-141.</p><p>Frymoyer J.W. Back pain and sciatica. N Engl J Med 1988; 318: 291-300.</p><p>Royal College of General Practitioners. Clinical Guidelines for the Management of Acute Low Back Pain. London: Royal College of General Practitioners, 1996 and 1999.</p><p>Hoogendoorn W.E., van Poppel M.N.M., Bongers P.M. et al. Systemic review of psychosocial factors at work and private life as risk factors for back pain. Spine 2000; 25: 2114-25.</p><p>Linton S.J. A review of psychological risk factors in back and neck pain. Spine 2000; 25: 1148-56.</p><p>Van Tulder M.W., Assendelft W.J.J., Koes B.W. et al. Spinal radiographic findings and nonspecific low back pain: a systematic review of observational studies. Spine 1997; 22: 427-34.</p><p>Jarvik J.G., Hollingworth W., Martin B. et al. Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial. JAMA 2003; 289: 2810-8.</p><p>Van Tulder M.W., Koes B.W., Bouter L.M. Conservative treatment of acute and chronic nonspecific low back pain: a systematic review of randomized controlled trials of the most common interventions. Spine 1997; 22: 2128-56.</p><p>De Craen A.J.M., Di Giulio G., Lampe- Schoenmaeckers A.J.E.M. et al. Analgesic efficacy and safety of paracetamol-codeine combinations versus paracetamol alone: a systematic review. Br Med J 1996; 313: 321-5.</p><p>Koes B.W., Scholten R.J.P.M., Mens J.M.A. et al. Efficacy of non-steroidal anti-inflammatory drugs for low back pain: a systematic review of randomised clinical trials. Ann Rheum Dis 1997; 56: 214-23.</p><p>Van Tulder M.W., Scholten R.J.P.M., Koes B.W. et al. Non-steroidal anti-inflammatory drugs (NSAIDs) for non-specific low back pain (Cochrane Review). In: The Cochrane Library, Issue 4, Oxford: Update Software 2000.</p><p>Henry D., Lim L.L.Y., Rodriguez L.A.G. et al. Variability in risk of gastrointestinal complications with individual non-steroidal anti-inflammatory drugs: results of a collaborative meta-analysis. Br Med J 1996; 312: 1563-6.</p><p>Van Tulder M.W., Touray T., Furlan A.D. et al. Muscle relaxants for non-specific low back pain (Cochrane Review). In: The Cochrane Library, Issue 1. Chichester, UK: John Wiley &amp; Sons, Ltd, 2004.15.</p><p>Bigos S., Bowyer O., Braen G. et al. Acute low back problems in adults. Clinical practice guideline no. 14. AHCPR publication no. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of health and Human Services. December 1994.</p><p>Van Tulder M., Becker A., Bekkering T. et al. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J 2006; 15(Suppl. 2): 169-91.</p><p>Данилов А.Б. Возможности применения тизанидина (сирдалуда) в клинической практике. Обзор литературы. РМЖ 2009; 17 (20): 1370.</p><p>Coward D.M. Tizanidine: Neuropharmacology and mechanism of action. Neurology 1994; 44(Suppl. 9): 6-11.</p><p>Hutchinson D.R., Daniels F. A multinational study in general practice to evaluate the effectiveness and tolerability of tizanidine in the treatment of painful muscle spasms. Br J Clin Res 1990; 1: 39-48.</p><p>Berry H., Hutchinson D.R. Tizanidine and ibuprofen in acute low-back pain: Results of a double-blind multicentre study in general practice. J Intern Med Res 1988; 16: 83-91.</p><p>Sirdalud Ternilin Asia-Pacific Study group. Efficacy and gastroprotective effects of tizanidine plus diclofenac versus placebo plus diclofenac in patients with painful muscle spasm. Curr Ther Res 1998; 59: 13-22.</p><p>Бадокин В.В. Применение сирдалуда в ревматологической практике. РМЖ 2005; 13(24): 1588-9.</p><p>Bettucci D., Testa L., Calzoni S. et al. Combination of tizanidine and amitriptyline in the prophylaxis of chronic tension - type headache: evaluation of efficacy and impact on quality of life. J Headache Pain 2006; 7(1): 34-6.</p><p>Воробьева О.В. Возможности альфа2- адренергических агонистов в лечении миофасциальной боли. РМЖ 2007; 5: 445-8.</p><p>McCleane G.J. Does Gabapentin have an analgesic effect on background, movement and referred pain? A randomised, doubleblind, placebo controlled study. Pain Clinic 2001; 13: 103-7.</p><p>Keitel W., Frerick H., Kuhn U. et al. Capsicum pain plaster in chronic non-specific low back pain. Arzneimittelforschung 2001; 51(11): 896-903.</p><p>Frerick H., Keitel W., Kuhn U. et al. Topical treatment of chronic low back pain with a capsicum plaster. Pain 2003; 106(1- 2): 59-64.</p><p>Koes B.W., Scholten R.J.P.M., Mens J.M.A. et al. Epidural steroid injections for low back pain and sciatica: an updated systematic review of randomized clinical trials. Pain Digest 1999; 9: 241-7.</p><p>Nelemans P.J., de Bie R.A., de Vet H.C.W. et al. Injection therapy for subacute and chronic benign low back pain. In: The Cochrane Library, Issue 4. Oxford: Update Software, 2001.</p><p>Watts R.W., Silagy C.A. A meta-analysis on the efficacy of epidural corticosteroids in the treatment of sciatica. Anaesth Intensive Care 1995; 23: 564-9.</p></div><br />

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