Experience with the use of chondroitin sulfate for pain in the back

Abstract

Chronic pain is still one of the most pressing problems of modern medicine. The article presents the main pathogenetic mechanisms of pain syndrome in osteoarthritis (OA). The recommendations of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) 2019 are presented. OA therapies, which indicate that when starting OA therapy, chondroitin sulfate (CS) or glucosamine sulfate (GS) should be considered as the First Step, then nonsteroidal antiinflammatory drugs (NSAIDs) should be added locally, and only then, if ineffective, oral NSAIDs are prescribed, with the exception of hip OA. Intramuscular (i/m) administration of CS can increase the bioavailability of the medicinal preparation (MP). The article also presents a clinical case of the use of LP CS (Artogistan; Bioiberica S.A., Spain) in a 58-year-old patient with pain in the lower back pain, OA of the intervertebral joints. Artogistan was prescribed at a dose of 100 mg (1 ml) every other day according to the scheme: the first 3 days of 100 mg (1 ml), starting from 4 days -200 mg (2 ml) every other day, a course of 35 injections. A positive response to therapy was received. According to the recommendations of ESCEO (2019) experts: 1) the use of CS as a basic therapy for OA is proven-from the first step and at all subsequent stages; 2) It is recommended to use drugs made exclusively from pharmaceutical substances of CS and GS; 3) CS and GS are prescribed for a long time (6-12 months), but not in courses. In the Russian Federation, parenteral forms of pharmaceutical-quality CS are available, the effectiveness of which is proven in RCTs.