A multidisciplinary approach to a patient with chronic pain
Kadyrova L.R.¹, Akarachkova E.S.², Kerimova K.S.³, Kotova O. V.¹, Lebedeva D.I.^4,5, Orlova A.S.⁶, Tkachev A.M.^7,8, Travnikova E.V.⁹, Tsareva E.V.<sup>10

1</sup> Kazan State Medical Academy — Branch Campus of the Russian Medical Academy of Continuing Professional Education
² International society of stress «Stress under control», Moscow
³ Medi SPA Technology, Moscow
⁴ Tyumen State Medical University
⁵ Regional Treatment and Rehabilitation Center, Tyumen
⁶ Sechenov University, Moscow
⁷ Medical Institute named after Berezin Sergey (MIBS), Moscow
⁸ Ltd “TMM-Clinic”, Volgograd
⁹ The Russian Presidential Academy of National Economy and Public Administration (RANEPA), Moscow
¹⁰ Ltd “Unison”, Moscow

Chronic pain is a frequent manifestation of joints and spine diseases, requiring an interdisciplinary approach to diagnostics and treatment. In patients with long-term pain syndromes, many comorbid conditions are formed, which significantly affects the course of the disease. Within the framework of comorbidity bone and muscle diseases occupy a special place. In prevalence, osteoarthrosis (OA) is a leader among other rheumatic diseases. A variety of pathogenetic mechanisms, involved in formation and progression of the OA, leads to development of various pain syndromes by origin. The treatment of OA is a difficult complex task, requiring joint efforts of physicians of different specialties: rheumatologists, orthopedists, neurologists, and surgeons. More and more attention is paid to a group of drugs called time-delayed drugs (SySADOA — symptomatic slow acting drugs for osteoarthritis), which have a symptomatic and possible structural and modifying effect. Alflutop is an effective and safe drug from the SySADOA group, with a wide spectrum of chondroprotective, anti-inflammatory, and analgesic properties, that allows it to be used also in neurological practice in complex therapy of patients with various musculoskeletal diseases (spondylarthrosis, tendonitis, enthesitis), including comorbid patients, if prolonged therapy and limiting nonsteroidal anti-inflammatory drugs intake are necessary.

Key words: back pain, osteoarthrosis, facet joint, spine, comorbidity, school of health.
For citation: Kadyrova L.R., Akarachkova E.S., Kerimova K.S. et al. A multidisciplinary approach to a patient with chronic pain // RMJ. 2018. № 7. P. 28–32.