Clinical aspects of management of patients with acute and chronic pain
DOI: 10.32364/2587-6821-2024-8-10-5
А.Е. Barulin, O.V. Kurushina, A.E. Puchkov
Volgograd State Medical University, Volgograd, Russian Federation
Pain syndrome is one of the most common reasons to seek medical help. The paper considers an issue of pain syndrome in patients with various diseases. Various pathogenetic variants of dorsalgia development in the setting of inflammatory and degenerative-dystrophic changes are presented. The main biomechanical and biochemical processes associated with the pain syndrome are summarized. Several features of the course and therapeutic methods of the back pain syndrome associated with ankylosing spondylitis, osteoarthritis, as well as gouty and rheumatoid arthritis are considered. The paper outlines general principles of therapy for acute and chronic nociceptive pain syndromes. Medicinal and non-medicinal therapeutic methods are discussed. Since specific and non-specific inflammatory reactions represent a key pathogenetic mechanism in most of the reviewed cases of acute and chronic pain syndrome, anti-inflammatory drugs play a leading role in the condition therapy. We considered the possibility to use nonsteroidal anti-inflammatory drugs (NSAIDs) and B vitamins.
Keywords: back pain, osteoarthritis, ankylosing spondylitis, rheumatoid arthritis, chronic pain syndrome, acute pain syndrome.
For citation: Barulin А.Е., Kurushina O.V., Puchkov A.E. Clinical aspects of management of patients with acute and chronic pain. Russian Medical Inquiry. 2024;8(10):576–581 (in Russ.). DOI: 10.32364/2587-6821-2024-8-10-5
About the authors:
Alexander E. Barulin — Dr. Sc. (Med.), Head of the Department of Neurology, Psychiatry, Manual Medicine, and Medical Rehabilitation, Institute of Continuous Medical and Pharmaceutical Education, Volgograd State Medical University; 1, Pavshikh Bortsov sq., Volgograd, 400131, Russian Federation; ORCID iD 0000-0001-7264-3580
Olga V. Kurushina — Dr. Sc. (Med.), Head of the Department of Neurology, Neurosurgery, and Medical Genetics, Volgograd State Medical University; 1, Pavshikh Bortsov sq., Volgograd, 400131, Russian Federation; ORCID iD 0000-0003-4364-0123
Andrey E. Puchkov — Head of the Neurological Department, Volgograd State Medical University Clinic No. 1, Assistant of the Department of Neurology, Psychiatry, Manual Medicine, and Medical Rehabilitation, Institute of Continuous Medical and Pharmaceutical Education, Volgograd State Medical University; 1, Pavshikh Bortsov sq., Volgograd, 400131, Russian Federation.
Contact information: Andrey E. Puchkov, e-mail: puchkov09@gmail.com
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 08.08.2024.
Revised 02.09.2024.
Accepted 25.09.2024.
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7. Барулин А.Е., Курушина О.В., Калинченко Б.М. Эффективность сочетанного применения миорелаксантов и топических форм НПВП в противоболевой терапии цервикалгии и цервикобрахиалгии. Медицинский алфавит. 2019;1(2):6–10. DOI: 10.33667/2078-5631-2019-1-2(377)-6-10Barulin A.E., Kurushina O.V., Kalinchenko B.M. Efficacy of combined use of muscle relaxants and topical forms of NSAIDs in anti-pain therapy of cervicalgia and cervicobihalgia. Medical alphabet. 2019;1(2):6–10 (in Russ.) DOI: 10.33667/2078-5631-2019-1-2(377)-6-10
8. Ung H., Brown J.E., Johnson K.A. et al. Multivariate classification of structural MRI data detects chronic low back pain. Cereb Cortex. 2014;24(4):1037–1044. DOI: 10.1093/ cercor/bhs378
9. May A. Chronic pain may change the structure of the brain. Pain. 2008;137(1):7–15. DOI: 10.1016/j.pain.2008.02.034
10. Курушина, О.В., Барулин А.Е. Влияние болевых установок на результаты лечения алгического синдрома. Вестник Российского университета дружбы народов. Серия: Медицина. 2010;4:298–299.Kurushina O.V., Barulin A.Ye. Influence of pain beliefs on resuts of algetic syndrome treatment. RUDN Journal of Medicine. 2010;(4):298–299 (in Russ.).
11. Fusco M., Skaper S.D., Coaccioli S. et al. Degenerative joint diseases and neuroinflammation. Pain Pract. 2017;17(4):522–532. DOI: 10.1111/papr.12551
12. Nathan C., Ding A. Nonresolving inflammation. Cell. 2010;140(6):871–882. DOI: 10.1016/j.cell.2010.02.029
13. Varrassi G., Fusco M., Coaccioli S., Paladini A. Chronic pain and neurodegenerative processes in elderly people. Pain Pract. 2015;15(1):1–3. DOI: 10.1111/papr.12254
14. Myers R.R., Campana W.M., Shubayev V.I. The role of neuroinflammation in neuropathic pain: mechanisms and therapeutic targets. Drug Discov Today. 2006;11(1–2):8–20. DOI: 10.1016/S1359-6446(05)03637-8
15. Rosa A.C., Fantozzi R. The role of histamine in neurogenic inflammation. Br J Pharmacol. 2013;170(1):38–45. DOI: 10.1111/bph.12266
16. Birklein F., Schmelz M. Neuropeptides, neurogenic inflammation and complex regional pain syndrome (CRPS). Neurosci Lett. 2008;437(3):199–202. DOI: 10.1016/j.neulet.2008.03.081
17. Давыдов О.С. Периферические и центральные механизмы перехода острой боли в хроническую и возможная роль ингибирования циклооксигеназы 2 в предотвращении хронизации болевого синдрома. Неврология, нейропсихиатрия, психосоматика. 2016;8(2):10–16. DOI: 10.14412/2074-2711-2016-2-10-16Davydov O.S. The peripheral and central mechanisms of transition of acute to chronic pain and the possible role of cyclooxygenase-2 inhibition in the prevention of pain syndrome chronization. Neurology, Neuropsychiatry, Psychosomatics. 2016;8(2):10–16 (in Russ.). DOI: 10.14412/2074-2711-2016-2-10-16
18. Voscopoulos C., Lema M. When does acute pain become chronic? Br J Anaesth. 2010;105(1 Suppl.):i69–i85. DOI: 10.1093/ bja/aeq323. 12
19. Koes B.W., van Tulder M.W., Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006;332(7555):1430–1434. DOI: 10.1136/ bmj.332.7555.1430
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