Gerontological aspects of back pain in rheumatology
Shostak N.A., Pravdyuk N.G., Klimenko A.A.
N.I. Pirogov Russian National Research Medical University, Moscow

More than 20% of Russian population is older than 60%. The most common disorders among elderly persons are cardiovascular diseases, oncology, and musculoskeletal diseases. Back pains in elderly persons are often associated with degenerative joint disease and other conditions, i.e., spondyloarthrosis and non-traumatic vertebral fractures due to the progressive decrease in bone mineral density as a result of osteoporosis. Every fourth fracture only is diagnosed by clinical manifestations since most fractures are not accompanied by either pain or neurological abnormalities. Pain may result from vertebral compression, periosteal hemorrhage, or paravertebral muscle spasm. Treatment strategy for back pain should include non-steroidal anti-inflammatory drugs (NSAIDs), topical therapy (NSAID-containing gels, creams, or liniments), and muscle relaxants (to reduce muscle spasms). Medical agents which stimulate the synthesis of cartilage matrix and suppress its destruction (i.e., chondroitin sulfate, glucosamine sulfate/hydrochloride) are indicated for spondyloarthritis. Vitamin D and calcium which are beneficial for fracture prevention are required for compression fractures (in the absence of contraindications).

Key words: spondyloarthrosis, vertebral fractures, osteoporosis, chondroitin sulfate, glucosamine sulfate, elderly patients.

For citation: Shostak N.A., Pravdyuk N.G., Klimenko A.A. Gerontological aspects of back pain in rheumatology // RMJ. 2016. № 22. P. 1518–1522.