Back pain is an actual interdisciplinary problem of modern medicine. The review summarizes current classification approaches to the nomenclature and nosology of this common syndrome. The paper includes the table of differential diagnosis of major dorsopathies (i.e., myofascial, arthropathic, myotonic, and segmental instability). The attention is mainly focused on facet arthropathy since facet joints are often affected by osteoarthrosis. Diagnostic potentialities of the complex interventional management approach to a patient with back pain which includes facet, epidural, or sacroiliac injections of local anesthetic and/or glucocorticoid are discussed. Facet joints can be easily visualized with spiral computed tomography. Non-steroidal anti-inflammatory drugs (NSAIDs) as well as symptom modifying slow-acting drugs (which contain chondroitin sulfate and glucosamine) are considered as a first-line treatment of facet arthropathy. The data on the efficacy and safety of therapeutic blocks of facet joints are presented. Performing manipulations under ultrasound control improves their accuracy. The role of glucocorticoids in the treatment of back pains is systematized. The table of comparative anti-inflammatory and mineralocorticoid activities of main glucocorticoids is adapted for local injections. An innovative method of facet pain syndrome treatment, radio-frequency denervation of intervertebral joins, is discussed. The current state of the field demonstrates that facet arthropathy is common amongst the patients with back pain. Complex interdisciplinary approach increases the effectiveness of therapeutic and diagnostic procedures.

Keywords: facet arthropathy, computed tomography of facet joints, non-steroidal anti-inflammatory drugs, glucocorticoids, chondroprotectors, local therapy.

For citation: Dolgova L.N., Krasivina I.G., Kirillov N.V. Facet arthropathies: selected issues of nomenclature, diagnosis, and therapy // RMJ. Rheumatology. 2016. № 2. P. 77–84.