Multidisciplinary options for the correction of chronic nonspecific low back pain syndrome (literature review)

Abstract

Chronic back pain is the complaint with which patients most often seek medical help from general practitioners, neurologists, surgeons, traumatologists and other subspecialists. Pain in the lower back can be either nonspecific, i. e., have no specific nosologic cause, or be specific, i. e., have a certain pathophysiologic mechanism of occurrence due to both spinal and extra-spinal causes. This fact determines the importance of complex and multidisciplinary assessment of the characteristics of chronic low back pain syndrome.The aim of the present study was to investigate the possibility of realizing a multidisciplinary approach in the treatment of nonspecific low back pain syndrome.Results. Low back pain is pain that is localized between the twelfth pair of ribs and the gluteal folds. It is not always possible to determine the source of pain when it is nonspecific; moreover, there is no convincing evidence that clarification of localization will favorably affect the course and outcome of the disease. There are three main causes of nonspecific low back pain: myofascial syndrome; pathology of joints and ligamentous apparatus of the spine; and lumbar osteochondrosis, which is a natural process of degeneration of spinal structures and is observed to varying degrees in all people, increasing significantly with age. It is believed that the pain syndrome of the back region has a multifaceted pathophysiology, which is influenced by somatic pathology, psychological and social factors. This explains the need for an integrated multidisciplinary approach to a particular patient and the compilation of an individual program of treatment, rehabilitation and prevention of subsequent exacerbations. Multidisciplinary approach means complex coordinated parallel work of specialists aimed at solving the problem of chronic pain.Conclusion. Multidisciplinary approach to the treatment of patients with chronic nonspecific low back pain syndrome is more effective than monotherapy, because it takes into account individual features of clinical symptoms, allows to carry out treatment and rehabilitation according to an individual plan, including a set of interrelated measures aimed at improving the quality of life of the patient and his functional capabilities.