General characteristics and features of the use of nonsteroidal anti-inflammatory drugs in the treatment of dorsopathies in clinical practice (literature review)

Abstract

Back pain ranks first among all non-communicable diseases in terms of the number of years of life lost due to poor health. At the same time, the choice of tactics for the treatment of dorsopathies presents certain difficulties, in particular, the choice of a nonsteroidal anti-inflammatory drug (NSAID), which depends on a number of factors. NSAIDs are effectively used in the treatment of musculoskeletal pain, but they have side effects, which determines the individual characteristics of their use. The article presents an overview of scientific data published in the sources MEDLINE, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Clinical Trials.gov, services for the exchange of research information on the clinical practice of NSAID use. The general characteristics and side effects of NSAIDs in clinical practice are analyzed in order to choose an effective and safe trajectory of their use in the treatment of dorsopathies. In the acute period of dorsopathy, the therapeutic effect should be aimed primarily at reducing pain. At the same time, the use of NSAIDs is necessary and justified, should include a detailed assessment of side effects, duration of use, alternative trajectories of drug and non-drug treatment. Numerous side effects of NSAIDs from the gastrointestinal tract, liver, cardiovascular system, allergic reactions, congenital anomalies in the fetus when using NSAIDs during pregnancy and other undesirable consequences, make it necessary to take the maximum possible measures to minimize adverse reactions and long-term undesirable consequences for the patient. Combined therapeutic effects, including, along with the use of NSAIDs, physiotherapy, physical therapy, massage, reflexotherapy, optimization of motor activity, optimization of posture under static loads, the use of cognitive behavioral therapy methods, is optimal from the standpoint of risk stratification and the expected clinical effect in patients with dorsopathy.