The treatment of musculoskeletal pain: from theory to practice
Averchenkova A.A.¹, Rachin A.P.<sup>2

1</sup> Smolensk Center for Kinesitherapy 
² «Russian Scientific Center for Medical Rehabilitation and Balneology», Moscow

Musculoskeletal pain (MSP) is one of the most widespread types of pain in clinical practice of the neurologist. MSPs are caused by nonspecific changes in vertebral structures, ligamentous apparatus and paravertebral muscles, and the pain pattern is determined mainly not by the degree of damage of these structures but by the development of muscular dysfunction, peripheral and central sensitization. Chronicization of this condition is the result of pathological functioning of peripheral and central sensory systems, a whole cascade of neurophysiological and neurochemical changes that support pain and the development of emotional and behavioral disorders (depression, generalized anxiety disorder, high personal anxiety, etc.). Therefore, in the treatment of pain, along with the traditional use of non-steroidal anti-inflammatory drugs and muscle relaxants, the neurologists use the drugs of various classes (anticonvulsants, antidepressants, selective activators of neuronal potassium channels - flupirtine (Nolodatak)), as well as psychotherapeutic techniques (for example, cognitive behavior therapy) and other non-pharmacological methods (manual therapy, acupuncture, kinesitherapy, surgical methods of denervation, etc.). Only the use of a complex of therapeutic measures makes it possible to effectively stop the pain syndrome, as well as to prevent the transition of MSP to a chronic form.

Key words: musculoskeletal pain, central sensitization, flupirtine, Nolodatak
For citation: Averchenkova A.A., Rachin A.P. The treatment of musculoskeletal pain: from theory to practice // RMJ. 2017. № 9. P. 681–686.