scholarly journals Tolperisone in the treatment of acute and chronic nonspecific back pain

2020 ◽  
Vol 12 (4) ◽  
pp. 137-142
Author(s):  
V. A. Golovacheva ◽  
A. A. Golovacheva ◽  
O. E. Zinovyeva ◽  
V. L. Golubev
Keyword(s):  
Clinical Trials ◽  
Back Pain ◽  
Randomized Trial ◽  
Muscle Relaxant ◽  
Large Scale ◽  
Muscle Relaxants ◽  
Good Tolerance ◽  
Vertebral Canal ◽  
Canal Stenosis ◽  
Inflammatory Drugs

Nonspecific back pain (NBP) is one of the most common reasons to see a neurologist or therapist. Acute (<4 weeks' duration), subacute (4 to 12 weeks), and chronic (>12 weeks) NBPs are recognized. The diagnosis of NBP is based on anamnestic data, somatic, neurological, and neurologic-and-orthopedic examination findings and on the exclusion of the specific causes of back pain, discogenic radiculopathy, and vertebral canal stenosis. Nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants are used in the pharmacotherapy of acute, subacute, and chronic NBP. Tolperisone is widely used as a muscle relaxant in Russia and in the countries of Europe and Asia. Clinical trials have shown the efficacy and good tolerance of tolperisone used alone and in combination with NSAIDs for NBP. The review presents clinical recommendations from different countries on the use of muscle relaxants in the treatment of acute and chronic NBP. It is concluded that a large-scale qualitative randomized trial should be conducted to investigate the efficacy of muscle relaxants, tolperisone in particular, in the treatment of acute, subacute, and chronic NBP.

scholarly journals Sacroiliac joint dysfunction: clinical presentations, diagnosis, treatment

2019 ◽  
Vol 11 (2S) ◽  
pp. 62-68 ◽  
Author(s):  
A. I. Isaikin ◽  
A. V. Kavelina ◽  
Yu. M. Shor ◽  
P. A. Merbaum ◽  
T. I. Shadyzheva
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Muscle Relaxant ◽  
Local Anesthetics ◽  
Sacroiliac Joint ◽  
Muscle Relaxants ◽  
Multimodal Approach ◽  
Clinical Presentations ◽  
Psychotherapeutic Techniques ◽  
Inflammatory Drugs

One of the most common anatomical sources of nonspecific back pain is sacroiliac joint (SIJ) injury. The paper gives data on the structure, features of diagnosis and treatment of pain caused by SIJ dysfunction. A multimodal approach, including psychotherapeutic techniques, kinesiotherapy, the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants, is recommended for chronic pain. The authors give their own experience with drug treatment of 51 patients (36 women and 15 men; mean age, 56.4±2.1 years) with SIJ dysfunction, by using periarticular blockages with local anesthetics and glucocorticoids or radiofrequency SIJ denervation. They note the efficiency of using Airtal® as a NSAID and Mydocalm® as a muscle relaxant.

scholarly journals Spinal pain: causes and treatment policy

2018 ◽  
Vol 12 (3) ◽  
pp. 53-60
Author(s):  
Yu. A. Olyunin
Keyword(s):  
Back Pain ◽  
Structural Changes ◽  
Pain Syndrome ◽  
Opioid Analgesics ◽  
Spinal Pain ◽  
Muscle Relaxants ◽  
Medical Problems ◽  
Relieve Pain ◽  
Inflammatory Drugs ◽  
Current Guidelines

Chronic pain in the spine is one of the most urgent medical problems. Clinical and instrumental studies fail to reveal that most patients with back pain have any structural changes that may contribute to its occurrence. It is considered that the pain may be caused by the strain of muscles and ligaments located in the lower back, by the overload of these segments, and by detraining. If the cause of the pain syndrome cannot be established, the pain in the spine is regarded as nonspecific. It is believed that behavioral, psychological, and social factors can play an important role in the development of pain. Therefore, current guidelines propose to apply a biopsychosocial approach in patients with back pain. At the same time, much attention is paid to patient self-treatment, exercise therapy, psychotherapy, and some other auxiliary methods. When nonpharmacological interventions are insufficiently effective, drug therapy is indicated. Nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol, opioid analgesics, and muscle relaxants are used to treat nonspecific spinal pain. Pharmacotherapy is usually initiated with the use of NSAIDs. They can effectively relieve pain sndrome, but the possibilities of their use in a large proportion of patients are significantly limited due to adverse reactions (ARs). Gastrointestinal and cardiovascular ARs most commonly occur. The likelihood of ARs can be substantially reduced by the use of aceclofenac (AirtalR) that is characterized by a favorable gastrointestinal and cardiovascular safety profile. Paracetamol, opioid analgesics, and muscle relaxants are also used in the combination treatment of these patients.

Randomized trial of a web-based intervention to address barriers to clinical trials.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6500-6500 ◽  
Author(s):  
Neal J. Meropol ◽  
Terrance Lynn Albrecht ◽  
Yu-Ning Wong ◽  
Al Bowen Benson ◽  
Joanne S. Buzaglo ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Decision Making ◽  
Clinical Trials ◽  
Randomized Trial ◽  
Large Scale ◽  
College Education ◽  
Phase Iii ◽  
Post Intervention ◽  
Web Based ◽  
Attitudinal Barriers

6500 Background: Cancer patients (pts) have knowledge and attitudinal barriers to participation in clinical trials (CT). We developed PRE-ACT (Preparatory Education About Clinical Trials), a tailored, interactive, web-based intervention to address these barriers and improve preparation for consideration of CT as a treatment option. Methods: We conducted a prospective, randomized, multicenter, phase III clinical trial of PRE-ACT vs. control (general text about CT excerpted from NCI materials). All assessments and interventions were conducted online. Cancer pts >18 years old were enrolled before initial oncologist consultation. Pts completed a baseline assessment including CT knowledge (19-item); CT attitudes (28-item); preparation for decision making (10-item); and validated measures of preferences for shared decision making and quality/length of life. PRE-ACT pts received a summary of their preferences and a list of their top CT barriers. Based on ranking of individual barriers, pts were presented with a video library of 30-90 second clips addressing their top barriers (10 maximum). After the educational intervention a follow up survey reassessed CT barriers and preparation. Results: 1255 pts were randomized; median age 59 (range 20-88); 58% female; 12% non-white / 2% Hispanic; 76.4% some college education. 1081 pts completed baseline and post-intervention assessments. The control and PRE-ACT groups both had improved knowledge, reduced attitudinal barriers, and improved preparation (p<.0001 for all comparisons). PRE-ACT was more effective than control in improving knowledge (p=.0006) and attitudes (p<.0001). Furthermore, pts in the PRE-ACT arm were more satisfied with the amount (p=.002) and format (<.0001) of information, and felt more prepared to consider CT (p=.0003). Conclusions: This large-scale randomized trial of a tailored, web-based, video intervention demonstrates that educational information delivered online before the oncologist visit can significantly reduce knowledge barriers and attitudinal barriers and improve preparation for consideration of clinical trials. Both text and PRE-ACT are effective, with greater improvements and satisfaction in the PRE-ACT group. Clinical trial information: NCT00750009.

scholarly journals Effectiveness of treatments for acute and subacute mechanical non-specific low back pain: a systematic review with network meta-analysis

2021 ◽  
pp. bjsports-2020-103596
Author(s):  
Silvia Gianola ◽  
Silvia Bargeri ◽  
Gabriele Del Castillo ◽  
Davide Corbetta ◽  
Andrea Turolla ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Muscle Relaxants ◽  
Low Back ◽  
Eligibility Criteria ◽  
Experienced Pain ◽  
Inflammatory Drugs

ObjectiveTo assess the effectiveness of interventions for acute and subacute non-specific low back pain (NS-LBP) based on pain and disability outcomes.DesignA systematic review of the literature with network meta-analysis.Data sourcesMedline, Embase and CENTRAL databases were searched from inception until 17 October 2020.Eligibility criteria for selecting studiesRandomised clinical trials (RCTs) involving adults with NS-LBP who experienced pain for less than 6 weeks (acute) or between 6 and 12 weeks (subacute).ResultsForty-six RCTs (n=8765) were included; risk of bias was low in 9 trials (19.6%), unclear in 20 (43.5%), and high in 17 (36.9%). At immediate-term follow-up, for pain decrease, the most efficacious treatments against an inert therapy were: exercise (standardised mean difference (SMD) −1.40; 95% confidence interval (CI) −2.41 to –0.40), heat wrap (SMD −1.38; 95% CI −2.60 to –0.17), opioids (SMD −0.86; 95% CI −1.62 to –0.10), manual therapy (SMD −0.72; 95% CI −1.40 to –0.04) and non-steroidal anti-inflammatory drugs (NSAIDs) (SMD −0.53; 95% CI −0.97 to –0.09). Similar findings were confirmed for disability reduction in non-pharmacological and pharmacological networks, including muscle relaxants (SMD -0.24; 95% CI -0.43 to -0.04). Mild or moderate adverse events were reported in the opioids (65.7%), NSAIDs (54.3%) and steroids (46.9%) trial arms.ConclusionWith uncertainty of evidence, NS-LBP should be managed with non-pharmacological treatments which seem to mitigate pain and disability at immediate-term. Among pharmacological interventions, NSAIDs and muscle relaxants appear to offer the best harm–benefit balance.

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