ОСОБЕННОСТИ ТЕРАПИИ ПРИ БОЛИ В СПИНЕ У БОЛЬНЫХ С ФАСЕТОЧНЫМ СИНДРОМОМ

Abstract

Back and neck pain are among the most common medical complaints in developed countries, with up to 66% of the population suffering from acute nonspecific back pain. As early as 1911, Goldthwaite J.E. proved that the articular joints of the spine can serve as a source of pain impulsation, with the proportion of facet syndrome increasing in older age groups, which can cause a clinical dilemma in identifying causes of back pain in the elderly. Like other synovial joints, the bicuspid joints, which are richly innervated by nociceptors, are also at risk of developing dystrophic changes with destruction of articular cartilage and, accordingly, the development of pain, which is provoked by stretching of the bicuspid joint capsule against the background of inflammatory modulators activation. Aim. The aim of the study was to investigate the efficacy of different methods of treatment of facet syndrome. Material and methods. An analytical review of publications in the scientific medical literature was performed. Results and discussion. In facetsyndrome, both local injection therapy with glucocorticosteroids, hyaluronic acid, local anesthetics, mesenchymal stem cells, and platelet-derived autoplasma are effective. Additional application of non-pharmacological treatments such as therapeutic gymnastics, physiotherapy, and therapeutic massage potentiates the effects of conventional conservative therapy. Radiofrequency laser neurotomy has been recognized as an alternative effective treatment for facet syndrome with a long-term positive effect. The choice of drugs and cellular substances for therapeutic blocks is wide enough and provides an adequate therapeutic approach to the treatment of nonspecific back pain caused by articular joint lesions. Conclusion. The diagnosis of facet syndrome is a diagnosis of exclusion, which requires a thorough differential diagnosis to choose further adequate treatment strategy.