Cognitive functional therapy and non-steroidal anti-inflammatory drugs in the treatment of low back pain

Abstract

A multidisciplinary approach including drug and non-drug methods is recommended for the treatment of chronic low back pain (CLBP). Kinesiotherapy, psychological methods, and nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to be highly effective for CLBP. All of the listed methods contribute to significant relief and relief of pain, increase the patient’s social and physical activity, and improve the emotional state. Psychological methods help patients cope with catastrophizing pain, increase daily activities, and reduce the likelihood of disease recurrence. Results from clinical studies and systematic reviews demonstrate the effectiveness of psychological techniques such as cognitive behavioral therapy (CBT) and mindfulness therapy (mindfulness) in the treatment of CLBP. Cognitive Functional Therapy (CFT) is a promising new psychological method that was created on the basis of CPT. Clinical studies have been conducted confirming the efficacy of CFT in CLBP. CFT is aimed at regular therapeutic exercises, normalization of motor activity with avoidance of excessive physical and static exertion, avoidance of sedentary lifestyle and normalization of sleep, which is often disturbed in chronic back pain. In practice, patients with CLBP often have low adherence to increased physical activity during the day, to therapeutic exercises. In most cases, this is due to the fact that in the first days of increased physical activity there is an increase in pain. Patients mistakenly fear further progression of pain and disease. Prescribing NSAIDs usually results in pain reduction as early as the first days of administration, so patients with chronic musculoskeletal pain have an increased desire to engage in physical activity and therapeutic exercises. The choice of a particular NSAID medication is made individually, taking into account the co-morbidities and the risk of possible side effects. We discuss the use of nimesulide in CLBP.