Diagnosis and treatment of acute lumbar pain

Abstract

Lumbar pain (LP) is one of the most frequent causes of appeal to a doctor and temporary disability. LP is most often caused by the musculoskeletal (non-specific) pathologies, less often discogenic radiculopathy, lumbar stenosis or specific pathology. The diagnosis of acute (up to 4 weeks) of skeletal muscle pain and discogenic radiculopathy is based on clinical manifestations and the exclusion of specific pathology, and neuroimaging is not required if there are no symptoms of a dangerous disease. Conducting X-ray, computed tomography or magnetic resonanse tomography in patients with skeletal-muscular LP does not improve the prognosis of the disease, does not affect the development of complications and chronizing the process, and the cost of the examination, the patient’s concern and the frequency of surgical interventions are unreasonably increasing. A patient with acute nonspecific LP or discogenic radiculopathy should be informed about the benign nature of the disease, a favorable forecast, expediency to maintain physical and social activity, avoid bed regime. Therapeutic gymnastics is not recommended for acute LP, but it is joined by reducing pain, it is advisable to teach the patient to avoid excessive static and physical exertion for the prevention of relapses and chronic. To facilitate pain, unnecessary anti-inflammatory drugs can be used in minimally effective doses and a short course, muscle relaxants. The use of group vitamins in both additional analgesics during acute LP is discussed, the results of their own studies on the treatment of patients with acute pain in the back and discogenic lumbosacral radiculopathy are analyzed. It is noted, that patients with acute LP are relatively rarely informed by doctors about its favorable forecast, the possibilities of the natural regression of the hernia of the disk and neurological symptoms at discogenic LP and radiculopathy.