scholarly journals Personalized, interdisciplinary approach to the treatment of chronic low back pain: clinical observation

2020 ◽  
pp. 64-69
Author(s):  
V. A. Golovacheva ◽  
A. A. Golovacheva

Nonspecific (musculoskeletal) pain is the most common cause of low back pain (LBP). Chronic nonspecific LBP is a particular problem, as it significantly reduces the quality of life and functional activity of the patient. The diagnosis of chronic non-specific LBP is made after exclusion of a specific cause of pain, discogenic radiculopathy and lumbar stenosis. Unfortunately, patients with chronic non-specific LBP are often misdiagnosed, pain chronization factors (“yellow flags”) are ignored and ineffective treatment is prescribed. Clinical observation of a patient with chronic non-specific LBP, who was initially wrongly diagnosed with spinal osteochondrosis and the treatment was ineffective, is presented. A personalized, multidisciplinary approach to treatment allowed the patient to cope with back pain and to return to his previous daily activities. The patient’s treatment plan included non-drug methods of treatment (educational conversation, physical activity, mindfulness, cognitive-behavioural therapy) and rational pharmacotherapy (non-steroidal anti-inflammatory drug, NSAID). Clinical observation showed the efficacy and good tolerability of NSAID - dexketoprofen (in the form of Dexalgin and Dexalgin 25), which was administered in a stepwise scheme for 5 days. According to modern recommendations, NSAIDs are first-line drugs in chronic non-specific LBP. The results of clinical studies on efficacy and safety in back pain of such NSAIDs as dexketoprofen and nimesulide are presented. In case of prolonged exacerbation the possibility of dexketoprofen prescription with subsequent transition to nimesulide is discussed.

2020 ◽  
Vol 18 (3) ◽  
pp. 188-194
Author(s):  
Ashiyat Kehinde Akodu ◽  
◽  
Thompson Adewale Ogunbiyi ◽  
Oluwaseun Akinleye Fapojuwo ◽  
◽  
...  

Introduction. Exercises have been shown to relieve symptoms in non-specific chronic low back pain (NSCLBP) patients. Aim. This study compared the effects of cognitive behavioural therapy (CBT) and core stabilization exercises (CSE) on pain-related disability, psychological status and sleep disturbance in patients with NSCLBP. Material and methods. This randomized controlled trial involved a total of thirty-seven (37) participants. They were randomly allotted into three groups [CBT (11), CSE (14) and control (12)]. The intervention was done once per week for duration of 60 minutes for the CBT group, 30 minutes for CSE group and 10 minutes for the control group twice per week for 8 consecutive weeks. Assessment of outcome was done at baseline, 4 weeks and 8 weeks. Data were analyzed using statistical package for social science version 25 at alpha level of less than 0.05. Results. The results of this study showed that there was significant improvement in the level of pain-related disability (p= 0.001), level of anxiety (p =0.001), depression (p = 0.01, p = 0.001, p =0.001) and sleep disturbance (p = 0.001) in all the groups (CBT, CSE, control) post treatment. Conclusion. CBT and CSE are both effective in the treatment of pain-related disability, sleep disturbance, and psychological status of NSCLBP patients.


2021 ◽  
Vol 85 (1) ◽  
pp. 3031-3036
Author(s):  
Mohamed Yehia Elabd ◽  
Enas Fawzy Youssef ◽  
Mohamed Ezzat Mohamed ◽  
Ahmed Samir Mohamed

2021 ◽  
Vol 6 (1) ◽  
pp. 11
Author(s):  
Arif Fadli ◽  
S. Th. Susilowati

Latar Belakang: Nyeri menjadi keluhan utama seseorang mengunjungi fasilitas pelayanan kesehatan. Jumlah pasien Chronic Low Back Pain (CLBP) terus meningkat dan membutuhkan biaya perawatan kesehatan yang besar. Intervensi biomedis dianggap gagal menyelesaikan keluhan non-spesifik CLBP.Tujuan: Untuk meringkas data literatur yang ada mengenai efektivitas Cognitive Behavioural Therapy (CBT) dengan Therapeutic Exercise Program (TEP) dalam pencegahan CLBP.Metode: Systematic review dan meta-analisis studi Randomized Control Trial dari database Pubmed, Googlescholar, Willey Online Library, Research Gate, Science Direct. Analisis data menggunakan aplikasi Revman 5.3 dengan ukuran efek Cohen’s d.Hasil: Ada 6 studi yang dimasukkan dalam penelitian ini. Hasil analisis 6 studi CBT dengan TEP dibandingkan dengan TEP saja pada intensitas nyeri menunjukkan ukuran efek yang besar (d: -1,51; 95%CI: -2,75 s/d -0,27; p <0,00001). Untuk parameter skor kecacatan menunjukkan ukuran efek yang besar (d: -1,87; 95% CI: -3,11 s/d -0,62; p <0,00001).Kesimpulan: Intervensi CBT dengan TEP lebih efektif dari pada TEP saja dalam pencegahan CLBP. Efektivitas hasil pencegahan CLBP dipengaruhi oleh keberhasilan pasien dalam menyelesaikan program rehabilitasi.


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