Хроническая боль в спине глазами ревматолога
https://doi.org/10.14412/1996-7012-2022-5-94-100
Аннотация
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.
Ключевые слова
ревматические заболевания,
хроническая боль в спине,
центральная сенситизация,
ревматоидный артрит,
ноцицептивная боль,
лечение
При поддержке: Статья спонсируется компанией «STADA»
Об авторах
Ю. А. Олюнин
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
Россия
Юрий Александрович Олюнин
115522, Москва, Каширское шоссе, 34А
А. М. Лила
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»;
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России
Россия
Россия
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
Литература
1. 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. Lancet. 2018 Nov 10;392(10159):1789-858. doi: 10.1016/S0140-6736(18)32279-7.
2. Walker BF. The prevalence of low back pain: a systematic review of the literature from 1966 to 1998. J Spinal Disord. 2000 Jun; 13(3):205-17. doi: 10.1097/00002517-200006000-00003.
3. Dutmer AL, Schiphorst Preuper HR, Soer R, et al. Personal and Societal Impact of Low Back Pain: The Groningen Spine Cohort. Spine (Phila Pa 1976). 2019 Dec 15;44(24): E1443-E1451. doi: 10.1097/BRS.0000000000003174.
4. Hartvigsen J, Hancock MJ, Kongsted A, et al; Lancet Low Back Pain Series Working Group. What low back pain is and why we need to pay attention. Lancet. 2018 Jun 9; 391(10137):2356-67. doi: 10.1016/S0140-6736(18)30480-X.
5. Da C Menezes Costa L, Maher CG, Hancock MJ, et al. The prognosis of acute and persistent low-back pain: a meta-analysis. CMAJ. 2012 Aug 7;184(11):E613-24. doi: 10.1503/cmaj.111271.
6. Hoy D, Bain C, Williams G, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012 Jun;64(6): 2028-37. doi: 10.1002/art.34347.
7. Groh AMR, Fournier DE, Battie MC, Seguin CA. Innervation of the Human Intervertebral Disc: A Scoping Review. Pain Med. 2021 Jun 4;22(6):1281-304. doi: 10.1093/pm/pnab070.
8. Herlin C, Kjaer P, Espeland A, et al. Modic changes-Their associations with low back pain and activity limitation: A systematic literature review and meta-analysis. PLoS One. 2018 Aug 1;13(8):e0200677. doi: 10.1371/journal.pone.0200677.
9. Raastad J, Reiman M, Coeytaux R, et al. The association between lumbar spine radiographic features and low back pain: a systematic review and meta-analysis. Semin Arthritis Rheum. 2015 Apr;44(5):571-85. doi: 10.1016/j.semarthrit.2014.10.006.
10. Deer T, Sayed D, Michels J, et al. A Review of Lumbar Spinal Stenosis with Intermittent Neurogenic Claudication: Disease and Diagnosis. Pain Med. 2019 Dec 1;20(Suppl 2) :S32-S44. doi: 10.1093/pm/pnz161.
11. Perolat R, Kastler A, Nicot B, et al. Facet joint syndrome: from diagnosis to interventional management. Insights Imaging. 2018 Oct; 9(5):773-89. doi: 10.1007/s13244-018-0638-x.
12. Cohen SP, Raja SN. Pathogenesis, diagnosis, and treatment of lumbar zygapophysial (facet) joint pain. Anesthesiology. 2007 Mar; 106(3):591-614. doi: 10.1097/00000542-200703000-00024.
13. Cohen SP, Chen Y, Neufeld NJ. Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment. Expert Rev Neurother. 2013 Jan;13(1):99-116. doi: 10.1586/ern.12.148.
14. Timgren J, Soinila S. Reversible pelvic asymmetry: an overlooked syndrome manifesting as scoliosis, apparent leg-length difference, and neurologic symptoms. J Manipulative Physiol Ther. 2006 Sep;29(7):561-5. doi: 10.1016/j.jmpt.2006.06.024.
15. Friberg O. Clinical symptoms and biomechanics of lumbar spine and hip joint in leg length inequality. Spine (Phila Pa 1976). 1983 Sep;8(6):643-51. doi: 10.1097/00007632-198309000-00010.
16. Bastiaenen CH, Bastiaanssen JM, de Bie RA. Pelvic girdle pain and lumbar pain in pregnancy: a cohort study of the consequences in terms of health and functioning. Spine 2006; 31:E149-55. Spine (Phila Pa 1976). 2006 Sep 15;31(20):2406; author reply 2406-7. doi: 10.1097/01.brs.0000240198.68466.49.
17. Ivanov AA, Kiapour A, Ebraheim NA, Goel V. Lumbar fusion leads to increases in angular motion and stress across sacroiliac joint: a finite element study. Spine (Phila Pa 1976). 2009 Mar 1;34(5):E162-9. doi: 10.1097/BRS.0b013e3181978ea3.
18. Chou LH, Slipman CW, Bhagia SM, et al. Inciting events initiating injection-proven sacroiliac joint syndrome. Pain Med. 2004 Mar; 5(1):26-32. doi: 10.1111/j.1526-4637.2004.04009.x.
19. Slipman CW, Jackson HB, Lipetz JS, et al. Sacroiliac joint pain referral zones. Arch Phys Med Rehabil. 2000 Mar;81(3):334-8. doi: 10.1016/s0003-9993(00)90080-7.
20. Young S, Aprill C, Laslett M. Correlation of clinical examination characteristics with three sources of chronic low back pain. Spine J. 2003 Nov-Dec;3(6):460-5. doi: 10.1016/s1529-9430(03)00151-7.
21. Hodges PW, Danneels L. Changes in Structure and Function of the Back Muscles in Low Back Pain: Different Time Points, Observations, and Mechanisms. J Orthop Sports Phys Ther. 2019 Jun;49(6):464-76. doi: 10.2519/jospt.2019.8827.
22. Rice DA, McNair PJ. Quadriceps arthrogenic muscle inhibition: neural mechanisms and treatment perspectives. Semin Arthritis Rheum. 2010 Dec;40(3):250-66. doi: 10.1016/j.semarthrit.2009.10.001.
23. Goubert D, De Pauw R, Meeus M, et al. Lumbar muscle structure and function in chronic versus recurrent low back pain: a crosssectional study. Spine J. 2017 Sep;17(9): 1285-96. doi: 10.1016/j.spinee.2017.04.025.
24. Özcan-Eksi EE, Eksi MS , Turgut VU, et al. Reciprocal relationship between multifidus and psoas at L4-L5 level in women with low back pain. Br J Neurosurg. 2021Apr;35(2): 220-8. doi: 10.1080/02688697.2020.1783434.
25. Imamura M, Chen J, Matsubayashi SR, et al. Changes in pressure pain threshold in patients with chronic nonspecific low back pain. Spine (Phila Pa 1976). 2013 Nov 15; 38(24):2098-107. doi: 10.1097/01.brs.0000435027.50317.d7.
26. Katz WA, Rothenberg R. Section 3: The nature of pain: pathophysiology. J Clin Rheumatol. 2005 Apr;11(2 Suppl):S11-5. doi: 10.1097/01.rhu.0000158686.43637.af.
27. Yu R, Gollub RL, Spaeth R, et al. Disrupted functional connectivity of the periaqueductal gray in chronic low back pain. Neuroimage Clin. 2014 Aug 23;6:100-8. doi: 10.1016/j.nicl.2014.08.019.
28. Kregel J, Meeus M, Malfliet A, et al. Structural and functional brain abnormalities in chronic low back pain: A systematic review. Semin Arthritis Rheum. 2015 Oct;45(2):229- 37. doi: 10.1016/j.semarthrit.2015.05.002.
29. Deyo RA, Mirza SK. CLINICAL PRACTICE. Herniated Lumbar Intervertebral Disk. N Engl J Med. 2016 May 5;374(18):1763-72. doi: 10.1056/NEJMcp1512658.
30. Van Hoeven L, Luime J, Han H, et al. Identifying axial spondyloarthritis in Dutch primary care patients, ages 20-45 years, with chronic low back pain. Arthritis Care Res (Hoboken). 2014 Mar;66(3):446-53. doi: 10.1002/acr.22180.
31. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017 Feb 18;389(10070):736-47. doi: 10.1016/S0140-6736(16)30970-9.
32. Taylor JB, Goode AP, George SZ, Cook CE. Incidence and risk factors for first-time incident low back pain: a systematic review and meta-analysis. Spine J. 2014 Oct 1;14(10): 2299-319. doi: 10.1016/j.spinee.2014.01.026.
33. Da C Menezes Costa L, Maher CG, Hancock MJ, et al. The prognosis of acute and persistent low-back pain: a meta-analysis. CMAJ. 2012 Aug 7;184(11):E613-24. doi: 10.1503/cmaj.111271.
34. Kongsted A, Kent P, Axen I, et al. What have we learned from ten years of trajectory research in low back pain? BMC Musculoskelet Disord. 2016 May 21;17:220. doi: 10.1186/s12891-016-1071-2.
35. Artus M, Campbell P, Mallen CD, et al. Generic prognostic factors for musculoskeletal pain in primary care: a systematic review. BMJ Open. 2017 Jan 17;7(1):e012901. doi: 10.1136/bmjopen-2016-012901.
36. Downie A, Williams CM, Henschke N, et al. Red flags to screen for malignancy and fracture in patients with low back pain: systematic review. BMJ. 2013 Dec 11;347:f7095. doi: 10.1136/bmj.f7095.
37. Luque Ramos A, Redeker I, Hoffmann F, et al. Comorbidities in Patients with Rheumatoid Arthritis and Their Association with Patient-reported Outcomes: Results of Claims Data Linked to Questionnaire Survey. J Rheumatol. 2019 Jun;46(6):564-71. doi: 10.3899/jrheum.180668.
38. Kothe R, Kohlmann T, Klink T, et al. Impact of low back pain on functional limitations, depressed mood and quality of life in patients with rheumatoid arthritis. Pain. 2007 Jan;127(1-2):103-8. doi: 10.1016/j.pain.2006.08.011.
39. Baykara RA, Bozgeyik Z, Akgul O, Ozgocmen S. Low back pain in patients with rheumatoid arthritis: clinical characteristics and impact of low back pain on functional ability and health related quality of life. J Back Musculoskelet Rehabil. 2013;26(4):367-74. doi: 10.3233/BMR-130393.
40. Yamada K, Suzuki A, Takahashi S, et al. Severe low back pain in patients with rheumatoid arthritis is associated with Disease Activity Score but not with radiological findings on plain X-rays. Mod Rheumatol. 2015 Jan;25(1): 56-61. doi: 10.3109/14397595.2014.924187.
41. Насонов ЕЛ, Олюнин ЮА, Лила АМ. Ревматоидный артрит: проблемы ремиссии и резистентности к терапии. Научнопрактическая ревматология. 2018;56(3): 263-71.
42. Лила АМ, Олюнин ЮА, Гордеев АВ. Оценка статуса больных ревматоидным артритом. Современные тенденции. Современная ревматология. 2020;14(2):7-13. doi: 10.14412/1996-7012-2020-2-7-13
43. Roodenrijs NMT, van der Goes MC, Welsing PMJ, et al. Difficult-to-treat rheumatoid arthritis: contributing factors and burden of disease. Rheumatology (Oxford). 2021 Aug 2;60(8):3778-88. doi: 10.1093/rheumatology/keaa860.
44. Олюнин ЮА. Оценка боли при ревматоидном артрите. Практическая значимость. Современная ревматология. 2019; 13(1):121-8. doi: 10.14412/1996-7012-2019-1-121-128
45. Рыбакова ВВ, Олюнин ЮА, Лихачева ЭВ, Насонов ЕЛ. Показатели активно сти ревматоидного артрита. Связь с психологическим статусом пациента. Современная ревматология. 2020;14(2):27-34. doi: 10.14412/1996-7012-2020-2-27-34
46. Henschke N, Ostelo RW, van Tulder MW, et al. Behavioural treatment for chronic lowback pain. Cochrane Database Syst Rev. 2010 Jul 7;2010(7):CD002014. doi: 10.1002/14651858.CD002014.pub3.
47. Kreiner DS, Matz P, Bono CM, et al. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of low back pain. Spine J. 2020 Jul; 20(7):998-1024. doi: 10.1016/j.spinee.2020.04.006.
48. Hayden JA, Ellis J, Ogilvie R, et al. Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis. J Physiother. 2021 Oct;67(4):252-62. doi: 10.1016/j.jphys.2021.09.004.
49. Furlan AD, Giraldo M, Baskwill A, et al. Massage for low-back pain. Cochrane Database Syst Rev. 2015 Sep 1;2015(9):CD001929. doi: 10.1002/14651858.CD001929.pub3.
50. Rubinstein SM, de Zoete A, van Middelkoop M, et al. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. BMJ. 2019 Mar 13;364:l689. doi: 10.1136/bmj.l689.
51. Romanт CL, Romanт D, Bonora C, Mineo G. Pregabalin, celecoxib, and their combination for treatment of chronic low-back pain. J Orthop Traumatol. 2009 Dec;10(4): 185-91. doi: 10.1007/s10195-009-0077-z.
52. Chou R, Deyo R, Friedly J, et al. Systemic Pharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017 Apr 4;166(7):480-92. doi: 10.7326/M16-2458.
53. Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4; 166(7):514-30. doi: 10.7326/M16-2367.
54. Malmstrom K, Sapre A, Couglin H, et al. Etoricoxib in acute pain associated with dental surgery: a randomized, double-blind, placebo- and active comparator-controlled doseranging study. Clin Ther. 2004 May;26(5): 667-79. doi: 10.1016/s0149-2918(04)90067-7.
55. Bickham K, Kivitz AJ, Mehta A, et al. Evaluation of two doses of etoricoxib, a COX-2 selective non-steroidal anti-inflammatory drug (NSAID), in the treatment of Rheumatoid Arthritis in a double-blind, randomized controlled trial. BMC Musculoskelet Disord. 2016 Aug 8;17:331. doi: 10.1186/s12891-016-1170-0.
56. Wang R, Dasgupta A, Ward MM. Comparative efficacy of non-steroidal anti-inflammatory drugs in ankylosing spondylitis: a Bayesian network meta-analysis of clinical trials. Ann Rheum Dis. 2016 Jun;75(6):1152-60. doi: 10.1136/annrheumdis-2015-207677.
57. Jung SY, Jang EJ, Nam SW, et al. Comparative effectiveness of oral pharmacologic interventions for knee osteoarthritis: A network meta-analysis. Mod Rheumatol. 2018 Nov; 28(6):1021-8. doi: 10.1080/14397595.2018.1439694.
58. Каратеев АЕ, Полищук ЕЮ, Филатова ЕС и др. Результаты открытого многоцентрового неинтервенционного исследования клинической эффективности и переносимости эторикоксиба при остеоартрите и неспецифической боли в спине с дополнительной оценкой влияния препарата на «центральные» проявления боли. Современная ревматология. 2022; 16(2):34-42. doi: 10.14412/1996-7012-2022-2-34-42
59. Feng X, Tian M, Zhang W, Mei H. Gastrointestinal safety of etoricoxib in osteoarthritis and rheumatoid arthritis: A metaanalysis. PLoS One. 2018 Jan 10;13(1): e0190798. doi: 10.1371/journal.pone.0190798.
60. Abdel Shaheed C, Maher CG, Williams KA, McLachlan AJ. Efficacy and tolerability of muscle relaxants for low back pain: Systematic review and meta-analysis. Eur J Pain. 2017 Feb;21(2):228-37. doi: 10.1002/ejp.907.
61. Moulin D, Boulanger A, Clark AJ, et al. Pharmacological management of chronic neuropathic pain: revised consensus statement from the Canadian Pain Society. Pain Res Manag. 2014 Nov-Dec;19(6):328-35. doi: 10.1155/2014/754693.
62. Shanthanna H, Gilron I, Rajarathinam M, et al. Benefits and safety of gabapentinoids in chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. PLoS Med. 2017 Aug 15;14(8):e1002369. doi: 10.1371/journal.pmed.1002369.
63. Robertson K, Marshman LAG, Plummer D, Downs E. Effect of Gabapentin vs Pregabalin on Pain Intensity in Adults With Chronic Sciatica: A Randomized Clinical Trial. JAMA Neurol. 2019 Jan 1;76(1):28-34. doi: 10.1001/jamaneurol.2018.3077.
64. Abdel Shaheed C, Maher CG, Williams KA, Day R, McLachlan AJ. Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain: A Systematic Review and Meta-analysis. JAMA Intern Med. 2016 Jul 1;176(7):958-68. doi: 10.1001/jamainternmed.2016.1251.
Рецензия
Для цитирования:
Олюнин ЮА, Лила АМ. Хроническая боль в спине глазами ревматолога. Современная ревматология. 2022;16(5):94-100. https://doi.org/10.14412/1996-7012-2022-5-94-100
For citation:
Olyunin YA, Lila AM. Chronic back pain from rheumatologist point of view. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2022;16(5):94-100. (In Russ.) https://doi.org/10.14412/1996-7012-2022-5-94-100
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