Non-specific Musculoskeletal Pain Research Articles

Efficiency of interval hypoxia-hyperoxytherapy in the rehabilitation of patients with nonspecific musculosceletal low back pain: results of а randomized placebo-controlled study

BACKGROUND: Considering the high prevalence and social significance of nonspecific musculoskeletal lower back pain, the use of innovative non-drug rehabilitation methods, particularly interval hypoxia-hyperoxytherapy, is relevant. AIM: To evaluate the efficiency of the interval hypoxia-hyperoxytherapy in the complex medical rehabilitation of patients with nonspecific musculoskeletal lower back pain. MATERIALS AND METHODS: This randomized placebo-controlled study enrolled 62 patients (male, n=35; female n=27, aged 34–63 years) with nonspecific musculoskeletal lower back pain. All patients were randomized into two groups. The study group (n=34) received 10 procedures of hypoxia–hyperoxytherapy, and the comparison group (n=28) received 10 placebo procedures of breathing therapy. All groups underwent a 2-week standard rehabilitation program: 10 procedures of low-intensity laser therapy and low-frequency electrostatic therapy and 10 group sessions of physical exercises. The study group was breathing hypoxic (FiO2 13%–15%) and hyperoxic (FiO2 up to 40%) gas mixture through a mask in the interval mode using “ReOxy.” The duration of 1–4 procedures was 30 min and 5–10 procedures took 40 min. The placebo procedures were performed using masks with atmospheric air hole. Rehabilitation diagnosis by domains b28013, b7303, b7600, and d4500 of the International Classification of Functioning, Disability and Health (ICF), back pain and general health on a 100-mm visual analog scale, Lequesne index, 10-m walking test, Spielberger–Khanin reactive anxiety test, and Beck depression inventory were evaluated at baseline and week 2. RESULTS: After 2 weeks the values of the qualifiers of ICF domains significantly improved in the study group, back pain decreased by 65.2% (р 0.01), the Lequesne index by 76.1% (р 0.01), the 10-m walking test by 42.4% (р 0.05), the reactive anxiety level by 50.5% (р 0.01), and depression symptoms by 69.7% (р 0.01), whereas the general health improved by 71.2% (р 0.01), with statistically significant differences from the comparison group in all parameters (р 0.05). CONCLUSION: 2-week rehabilitation program, including interval hypoxia-hyperoxytherapy, reduces back pain and improves rehabilitation diagnosis based on the ICF, general health, functional status and psychoemotional state in patients with nonspecific musculoskeletal lower back pain.

Therapeutic outcomes in patients with acute non-specific (musculoskeletal) pain according to the FORTE (ФОРТЕ) observational study

Therapeutic outcomes in patients with acute non-specific (musculoskeletal) pain according to the FORTE (ФОРТЕ) observational study

Atypical presentation of tight filum terminale with thoracic disc herniation: a case report

BackgroundTight filum terminale is a rare and challenging condition to diagnose because it presents with nonspecific symptoms and unclear imaging findings. This report documents an atypical case of tight filum terminale.Case presentationThe patient was a previously healthy Asian 18-year-old male presenting with recurrent upper extremity and back pain, initially treated as nonspecific musculoskeletal pain. Notably, the patient’s symptoms were inconsistent with the dermatome, showing no correlation with his skin’s sensory innervation areas. In contrast to typical tight filum terminale presentations focused on lower extremity and lumbar region disturbances, this patient experienced pain and weakness predominantly in the upper extremities and back, hypothesized to result from traction myelopathy exacerbated by thoracic disc herniation. Investigations including blood and nerve function tests were inconclusive. However, a magnetic resonance imaging scan revealed a combination of tight filum terminale and tiny thoracic disc herniation. A diagnosis of tethered spinal cord syndrome was confirmed following further tests and imaging. The filum terminale was surgically removed, resolving the symptoms at a 7-month follow-up.ConclusionsThis case underlines the importance of including tight filum terminale as a differential diagnosis in cases of unexplained upper or lower extremity pain. Primary care practitioners, particularly those managing undefined symptoms, should consider tight filum terminale in their diagnostic approach.

Comparative analysis of the use of original and standard methods of rehabilitation treatment of dorsopathy

Introduction. The increase in the number of requests for medical help for pain in dorsopathy determines the relevance of this problem. Among all the conditions included in the Health Expenditure Survey, non-specific musculoskeletal back pain ranks first in the world. A special place belongs to cervicothoracic dorsopathy (CТD), which are the most common in developed countries and are characterized by a variety of clinical forms. There is a need to develop safe and effective complexes for the medical rehabilitation of patients with СТD. The complex method of СТD treating with the obligatory use of drug and non-drug methods of treatment prescribed together or sequentially in one complex, in our opinion, is the most optimal.Aim. To conduct a comparative evaluation of the therapeutic efficacy of restorative treatment methods in patients with cervicothoracic dorsopathy.Materials and methods. Patients with cervicothoracic dorsopathy (n = 220), stratified into 2 comparable groups, were studied, to whom the original (n = 155) and standard (n = 65) methods of restorative treatment were applied. The original method of treatment assumed a combined therapeutic effect with the use of drug therapy and a rehabilitation complex of physiotherapeutic and psychotherapeutic sessions. Statistical analysis included a comparative assessment of the intensity of the pain syndrome, static-dynamic and reflex disorders before and after the therapy.Results. The original and standard methods used in the course of the study statistically significantly (p < 0.05) reduced the intensity of the pain syndrome and reduced the frequency of reflex disorders. At the same time, the use of the original method of therapy was more effective (p < 0.05) in reducing the severity of the pain syndrome and reducing the frequency of reflex disorders in subgroups of patients, both with uncomplicated and complicated forms of cervicothoracic dorsopathy. The use of a standard method of therapeutic effect significantly reduced the frequency of manifestation of static-dynamic disorders in the group with uncomplicated forms of dorsopathy, while in patients with complicated forms of cervicothoracic dorsopathy, no therapeutic effect was achieved.Conclusions. The original method of therapy has confirmed its effectiveness, which indicates the need and justification for the use of combined restorative treatment of patients with cervicothoracic dorsopathy.

Diagnosis and treatment of dorsalgia in outpatient practice

Dorsalgia − nonspecific back pain is the leader in the number of requests for medical help. Nonspecific musculoskeletal pain accounts for up to 80–90% of all pain syndromes. Back pain can be provoked by professional static-dynamic overloads, violations of the statics of the musculoskeletal system, exposure to cold and/or vibration, overweight, hereditary factors, etc. In outpatient practice, doctors often have to deal with various forms and clinical manifestations of dorsalgia. The leading role in the diagnosis is given to the physical examination of the patient. With the active collection of complaints and anamnesis, the doctor has the opportunity to identify the leading problem that prompted the patient to seek medical help, clarify the localization of the process, the time of occurrence and the sequence of symptoms, which allows you to fully imagine the picture of the disease and differentiate between simultaneously occurring nosologies. The identification of the affected structure, which is the root cause of musculoskeletal pain, does not affect the appointment of basic drug therapy, but it is absolutely necessary when conducting local injection therapy, as well as a number of non-drug treatment methods. Among the pharmacological drugs used to treat musculoskeletal pain, the priority remains for NSAIDs, the choice of which, first of all, is dictated by its safety. The favorable safety profile of Nimesil® (nimesulide) has been confirmed by numerous domestic and foreign studies. Nimesulide is registered in 50 countries for the treatment of pain syndromes, and is also used as an antipyretic and anti-inflammatory drug. According to the results of a study in the Russian Federation, Nimesil® (nimesulide) turned out to be the most frequently prescribed drug, which is due to its high effectiveness and ability to accumulate in therapeutic concentration in the focus of inflammation. In addition to pharmacotherapy, the treatment regimen for musculoskeletal pain should include, on a parity basis, non-drug treatment methods that allow correction of pathobiomechanical changes. If ignored, in many cases, drug anesthesia does not lead to the desired effect, which can contribute to the chronization of pain. The described clinical case illustrates the simultaneous course of two variants of dorsalgia in the patient, different in localization, clinical manifestations, severity and duration of the course.

Скелетно-мышечная боль: патогенетические, диагностические особенности, принципы медикаментозного и восстановительного лечения

Low back pain is one of the most common reasons for visits to a neurologist. The prevalence of Low back pain increases with age. The main causes of Low back pain include nonspecific (musculoskeletal) pain, compression radiculopathy, lumbar stenosis, as well as specific pain caused by “serious pathology” (for example: tumor, fracture, infection, osteoporosis, etc.). Musculoskeletal pain is one of the common causes of temporary disability, ahead of cardiovascular diseases and cancer. According to numerous literature data from both domestic and foreign authors, pain in the neck and lower back reaches 80-90% in the population. The relevance of the problem is due to the progressive course of the disease, as well as its frequent occurrence in people of working age. Many authors point to a higher incidence, as well as a more severe course of the disease, in people who have unfavorable production factors, which include heavy physical labor, static loads in non-physiological positions, monotony of the work process, hypothermia and overheating, as well as significant psycho-emotional stress. The review presents data on the pathogenetic, clinical and diagnostic features of musculoskeletal pain, as well as discloses aspects of drug therapy and describes methods of restorative treatment of musculoskeletal pain. Based on the above critical review of the literature on musculoskeletal pain, it should be noted that musculoskeletal pain is a fairly common pathology that occurs in almost half of the population. Drug treatment of musculoskeletal pain is not always effective, which necessitates a unified multidisciplinary approach for specialists dealing with this pathology, with a wider involvement of manual therapy and physiotherapy in the complex of rehabilitation measures, which will increase the effectiveness of the treatment, will reduce the incidence of musculoskeletal pain, and will also significantly increase the period of remission.

Content and Quality of Mobile Apps for the Monitoring of Musculoskeletal or Neuropathic Pain in Australia: Systematic Evaluation.

Mobile apps offer a potential mechanism for people with persistent pain to monitor pain levels conveniently within their own environment and for clinicians to remotely monitor their patients' pain. However, the quality of currently available apps and the usefulness of included features from a clinical perspective are not known. The aim of this study was to examine the content and quality of currently available smartphone apps designed for monitoring the intensity or presence of musculoskeletal or neuropathic pain. A systematic search was performed in the Australian Apple and Google Play stores. Apps were included if they were designed to monitor the intensity or presence of musculoskeletal or neuropathic pain and were available in the English language within the Australian app stores. Data pertaining to the intended use of the app and clinical population were extracted by using a custom-designed data extraction form, and app quality was assessed by using the 23-item Mobile App Rating Scale. Of the 2190 apps screened, 49 met the inclusion criteria. Apps were primarily designed for adult users (36/49, 73%) with nonspecific musculoskeletal or neuropathic pain conditions, arthritis, and joint pain. All apps monitored pain intensity, with almost half (23/49, 47%) also specifying pain location. Overall, the mean quality scores from the Mobile App Rating Scale ranged from 1.5 to 4.4 (out of 5.0). Between 20% (10/49) and 22% (11/49) of apps involved clinicians, consumers, or both in their development, and 20% (10/49) had published literature related to the development or use of the app in clinical scenarios. Although 71% (35/49) had data sharing features, only 5 apps enabled client-clinician communication through the app. The overall quality of mobile apps that are currently available for monitoring pain intensity is acceptable. Presently, mobile apps for remote pain monitoring lack functionality for clinicians to view data between consults. Both users and clinicians should be aware of the limitations of these apps and make informed choices in using or recommending apps that best suit the clinical need.

Clinical diversity and main directions of medical rehabilitation of dorsopathies of cervical-thoracic localization

Introduction. The high prevalence and increase in cases of seeking medical help for pain in dorsopathies determines the relevance of this problem. Among all the conditions included in the study of health care costs, non-specific musculoskeletal back pain ranks first in the world. A special place belongs to cervicothoracic dorsopathy (CTD), which are most common in developed countries and are characterized by a variety of clinical forms. In our opinion, a comprehensive method of treating CTD with the mandatory use of non-drug methods of therapy is the most optimal.Aim. Determination of the relationship between the pathogenetic form of CTD (verification of pain triggers) and a personalized method of treating patients, containing a combination of drug therapy and a rehabilitation complex of physiotherapeutic, psychotherapeutic effects.Materials and methods. Patients with CTD were included in the study. Neurological status assessment and biomechanical tests were carried out for accurate clinical verification of pathogenetic forms of CTD. Depending on the choice of treatment, respondents were stratified into comparable groups. The main group included patients to whom the original technique was applied, which implied a combination of drug therapy, a complex of rehabilitation physiotherapy and psychotherapeutic effects (n = 155), the control group (n = 65) – respondents who received a standard course of therapy. The statistical analysis included a comparative assessment of the intensity of pain syndrome, static-dynamic and reflex disorders before and after therapy.Results. Both methods have shown their effectiveness. The original technique more effectively reduced the intensity of pain syndrome, reduced the frequency of reflex disorders (p < 0.05), significantly reduced static-dynamic disorders in all subgroups (p < 0.05), while the standard significantly reduced them only in the subgroup with uncomplicated forms of CTD, without achieving a therapeutic effect in complicated CTD.Conclusion. The original method of therapy of patients with HCG has confirmed its effectiveness.

Comorbidity in back pain

A significant problem of modern medicine is the presence of several diseases in the same patient, which complicates not only the diagnosis of each of them, but also therapy. It is necessary to distinguish between the terms “comorbidity”, “multimorbidity” and “polymorbidity”. The principles of therapy for comorbid patients differ from those for patients with mononosology. А large number of Russian and foreign studies have shown that patients with chronic pain syndromes, including chronic back pain, often have a number of comorbid conditions. In particular, in patients with osteoarthritis, which is one of the most common causes of back pain, diseases of the cardiovascular system, lungs, gastrointestinal tract, diabetes mellitus, and obesity are more often recorded. The article describes a clinical case of a patient with the simultaneous presence of several diseases: myofascial pain syndrome, peroneal tunnel neuropathy, diabetes type 2, polyosteoarthritis, joint hypermobility syndrome, herniated disc, obesity. At the same time, some of these diseases are comorbid, while the other part is a multimorbid disease, which must be taken into account when making a diagnosis and selecting therapy. In addition, the described case from practice illustrates the priority of the clinical method of examining a patient over paraclinical ones. The choice of pharmacological drugs and non-drug methods of treatment recommended to the patient was dictated by the mixed nature of the pain. A non-steroidal anti-inflammatory drug, SYSADOA, and a muscle relaxant have been recommended to combat non-specific musculoskeletal pain. Neuropathic pain treatment, in accordance with clinical recommendations, the following groups of drugs were included: gabapentinoids, vitamins B, anticholinesterases.

Demographic and clinical factors associated with psychological wellbeing in people with chronic, non-specific musculoskeletal pain engaged in multimodal rehabilitation: -a cross-sectional study with a correlational design.

To investigate which demographic and clinical factors were associated with psychological wellbeing in working-aged people in multimodal rehabilitation for musculoskeletal disorders. 116 participants met the criteria for inclusion: persistent or intermittent pain for at least three months; pain that adversely impacts daily life; potential for active change despite pain; no co-morbidity or condition that will hinder participation in the rehabilitation program. Primary outcome was psychological wellbeing and independent measures were general, physical and mental health, pain intensity, limitations in daily life, depression and sleep. The results show decreased odds of psychological wellbeing for persons rating high on depression. The results remained significant after adjusting for sex and age. Being a woman increased the odds of high psychological wellbeing. Logistic regression showed that psychological wellbeing was not significantly associated with pain intensity; sleep; functional limitations; general, physical, or mental health. None of the other independent variables was significantly associated with high vs. low psychological wellbeing. Depression turned out to be significantly related to psychological wellbeing, contrary to pain and limitations in daily life. If further studies with larger, random samples can confirm these results, this knowledge may be important both in clinical settings and in future research.

Evaluation of Vitamin D Levels in Patients Presenting Nonspecific Musculoskeletal Pain at a Tertiary Care Hospital: A Cross Sectional Study

Introduction: Vitamin D insufficiency affects nearly 50% of the population worldwide. vitamin D deficiency involve the musculoskeletal system leading to proximal muscle weakness, bone pain, and osteomalacia which is largely unrecognized by both physicians and patients. The early detection of deficiency plays important role to prevent those diseases. The aim of the study is to find to evaluate the association of chronic low back pain with levels of vitamin D in the affected population. Methods: This observational study was carried out from January 2021 to December 2021 at a tertiary care hospital. Patients aged 18 years and above presenting with non-specific complaints of general body pain/back pain/tiredness/weakness on working and walking with no other symptoms such as injury or known medical illness and no relief of the pain symptoms with routine treatments with analgesics and rest and physiotherapy were screened for Vitamin D levels. Results: Out of 580 patients tested, 478 (82.4%) of the study population had below-normal vitamin D, of the 49.1% had deficiency, 33.3% had insufficiency and 17.5% had sufficient vitamin D level. The proportion of patients Vitamin D deficiency is higher in the age group 30-59 whereas insufficiency was higher in the age group 20-39 compared to other age groups and it was found statically significant. Conclusion: Importance has to be given to adequate vitamin D supplementation in the patents vitamin D deficiency.

Delayed Presentation of SARS-CoV-2–Related Pericarditis in a Professional Soccer Player: A Case Report

BACKGROUND: Pulmonary and extrapulmonary manifestations may accompany SARS-CoV-2 infection. Myocarditis and pericarditis are the most common cardiovascular complications after SARS-CoV-2 infection. Pericarditis, a common cause of cardiac chest pain, results from inflammation of the pericardium, commonly caused by a viral infection. It may be misinterpreted as nonspecific musculoskeletal pain. CASE PRESENTATION: A 27-year-old professional soccer player who tested positive for SARS-CoV-2 was admitted to the hospital with dyspnea and fever and ultimately diagnosed with right interstitial pneumonia. He gradually returned to play, after negative cardiac examinations. However, 40 days after a postinfection negative viral test, he experienced new onset mild chest pain. A physical assessment revealed musculoskeletal pain, and myofascial treatments were undertaken the day after. After 17 days without symptoms, the athlete suffered from worsening chest pain. He underwent a cardiac examination that confirmed the clinical suspicion of pericarditis, despite the previous negative cardiac examinations. TREATMENT AND FOLLOW-UP: The athlete was temporarily disqualified from training and competitions, and pharmacological therapy was started. After the resolution of symptoms and pericardial effusion, the athlete gradually returned to play without any sequelae. DISCUSSION: The diagnosis of pericarditis is sometimes delayed because of the misinterpretation of its symptoms. This case report highlights the importance of a comprehensive clinical assessment and the benefits of multidisciplinary management, particularly during the COVID-19 era, to diagnose pericarditis even if an athlete has recently been screened. JOSPT Cases 2022;2(4):255–261. Epub: 17 October 2022. doi:10.2519/josptcases.2022.11117

Hypovitaminosis D Causing Idiopathic Musculoskeletal Pain in Children

OBJECTIVES To determine the frequency of hypovitaminosis D in children presenting with Idiopathic musculoskeletal pain IMSP). METHODOLOGY The cross-sectional research was carried out at Peshawar’s Hayatabad Medical Complex’s Department of Pediatrics. The study duration was 6 months. The study comprised 151 patients with non-specific musculoskeletal pain who were tested for vitamin D levels to diagnose hypovitaminosis. RESULTS The age range of the participants was 3 to 15 years with a male predominance of 72.8%. The sample’s average the weight was above the 25 percentile. Hypovitaminosis D was found in 23.2%. Decreased sun exposure was documented in 82.85% of cases with hypovitaminosis. Hypocalcemia, hypophosphatemia and increased alkaline phosphatase were documented in 71.4%, 11.4% and 42.8% participants respectively with hypovitaminosis. CONCLUSION Hypovitaminosis D Is one of the risk factors for non-specific musculoskeletal pain but the current study revealed only 23.2% of participants had hypovitaminosis and inadequate sun exposure was a major risk factor for hypovitaminosis.

A personalized approach to the management of patients with chronic nonspecific back pain

Back pain is one of the most common causes of a doctor visit and occupy the first place among all non-infectious diseases in terms of the number of years of life, lost due to persistent deterioration in health. Nonspecific (musculoskeletal) pain represents the most common cause of pain and can be caused by the intervertebral disc extrusion, the lesion of the facet joints, the sacroiliac joints pain (SJP), the myofascial syndrome. A comprehensive (interdisciplinary) approach to the treatment of chronic back pain is aimed not only at reducing pain, but also at increasing physical, social and domestic activity, improving the emotional state, and developing effective stereotypes of behavior. The personalized approach is based on the patient clarifying both anatomical causes of pain and social and psychological, including erroneous ideas about the causes of back pain and its forecast, depression, increased anxiety and insomnia. Kinesitherapy represents the most effective direction when conducting patients with chronic back pain and should be combined with avoiding excessive static and physical exertion. In addition to therapeutic exercises, regular walks are of great importance, the intensity and volume of which can gradually increase. Psychological methods of therapy, mainly cognitive-behavioral therapy (CBT), are effective for chronic nonspecific back pain, they also use in the presence of emotional disorders and insomnia. In case of damage to the facet joints, the SJP, combined osteoarthritis of the knee and hip joints for chronic back pain as additional therapy, combined drugs of chondroitin sulfate and glucosamine sulfate are used. Unfortunately, in our country, a personalized approach is rarely used, including the CBT, but its use can help many patients with chronic back pain.

'Down to the person, the individual patient themselves': A qualitative study of treatment decision-making for shoulder pain.

IntroductionMany inconsistencies have been identified in the translation of evidence‐based treatment recommendations for musculoskeletal shoulder pain into healthcare services, with little known about factors influencing decision‐making. The objective of this study was to explore the views and experiences of healthcare providers (HCPs) and people living with shoulder pain on treatment decision‐making.MethodsAdopting a qualitative design, purposeful sampling was employed to recruit 13 individuals with nonspecific musculoskeletal shoulder pain and 30 HCPs. Data were collected through 1:1 semi‐structured interviews and analysed using an approach informed by Constructivist Grounded Theory. To facilitate analysis, two patient and public involvement (PPI) meetings were conducted.ResultsMost participants (69%) had shoulder pain of ≥1‐year duration. Biomechanical beliefs about shoulder pain predominated and were heavily influential in decision‐making for both patients and HCPs. Despite a consensus that therapeutic alliance facilitated decision‐making, the extent of collaboration between HCPs and patients in treatment decision‐making was rather limited. In addition to condition‐specific factors, Individual patient characteristics and resources also influenced treatment decisions.ConclusionFindings revealed the complexity of the decision‐making process for both patients and HCPs, exposing substantial gaps between the reported views and experiences of participants and the principles of client‐centred and evidence‐based practice. There is a pressing need to enhance the translation of evidence‐based knowledge into practice in this clinical area.Patient or Public ContributionIn line with a consultative approach to collaborative data analysis, a subgroup of participants attended two PPI meetings to provide commentary and feedback on preliminary findings.

Working conditions and prevalence of musculoskeletal pain in metalworking machine operators

The high prevalence of musculoskeletal syndrome (MSS), which causes absence from work and disability and significant treatment costs, determines the relevance of studying the features of its formation, including in connection with production factors. The study aims to determine the hygienic assessment of working conditions and the prevalence of musculoskeletal pain in various departments of the musculoskeletal system of machine-building workers in metalworking. The researchers formed observation groups: operators of metalworking machines with an experience of 1-5 years and 6-10 years, comparison groups - administrative and technical personnel on the principle of the same age and experience. Time-lapse studies allowed us to assess the severity and intensity of the work. In addition, we have studied the prevalence and nature of complaints using a questionnaire. Scientists have established the leading production factors that determine the severity of the work of machine operators: weight of the lifted and moved cargo; body tilts; the working pose of "standing with the tilt" (class working conditions 3.2). We identified a higher prevalence of complaints of pain in different parts of the spine; they are more intense, a marked increase in the majority of pain in the dynamics of employment, the relationship of their origin working in professional teams of operators compared to the control (p≤0,01-0,001). The calculation of the Pearson conjugacy coefficient confirmed a pronounced relationship between the prevalence of MSS and the severity of childbirth. The authors have established a high and very high degree of etiological conditionality of the MSS by the nature of the work. Factors of the work process of machine operators (working pose "standing with a tilt", lifting and carrying weights, torso bends) cause the appearance of nonspecific musculoskeletal pain. All this should be taken into account when planning preventive measures.

Working conditions and prevalence of musculoskeletal pain in metalworking machine operators

The high prevalence of musculoskeletal syndrome (MSS), which causes absence from work and disability and significant treatment costs, determines the relevance of studying the features of its formation, including in connection with production factors. The study aims to determine the hygienic assessment of working conditions and the prevalence of musculoskeletal pain in various departments of the musculoskeletal system of machine-building workers in metalworking. The researchers formed observation groups: operators of metalworking machines with an experience of 1-5 years and 6-10 years, comparison groups - administrative and technical personnel on the principle of the same age and experience. Time-lapse studies allowed us to assess the severity and intensity of the work. In addition, we have studied the prevalence and nature of complaints using a questionnaire. Scientists have established the leading production factors that determine the severity of the work of machine operators: weight of the lifted and moved cargo; body tilts; the working pose of "standing with the tilt" (class working conditions 3.2). We identified a higher prevalence of complaints of pain in different parts of the spine; they are more intense, a marked increase in the majority of pain in the dynamics of employment, the relationship of their origin working in professional teams of operators compared to the control (p≤0,01-0,001). The calculation of the Pearson conjugacy coefficient confirmed a pronounced relationship between the prevalence of MSS and the severity of childbirth. The authors have established a high and very high degree of etiological conditionality of the MSS by the nature of the work. Factors of the work process of machine operators (working pose "standing with a tilt", lifting and carrying weights, torso bends) cause the appearance of nonspecific musculoskeletal pain. All this should be taken into account when planning preventive measures.

Evaluation of the therapeutic efficacy of original and generic meloxicam in the treatment of acute neck pain

Introduction. In the structure of the global burden of diseases, back pain ranks first in the world in the list of causes of disability. Neck pain is one of the most common diseases of the musculoskeletal system. An integral part of the strategy for the treatment of acute neck pain is the use of original nonsteroidal anti-inflammatory drugs (NSAIDs) with high proven effectiveness.Objective. To conduct a comparative analysis of the therapeutic efficacy of the original drug meloxicam (Movalis) and its generic (Amelotex) in the treatment of patients with acute nonspecific musculoskeletal pain of cervical localization.Materials and methods. The article provides an assessment of the therapeutic effectiveness of the original drug meloxicam (Movalis) and its generic (Amelotex) in the treatment of patients with acute neck pain. Comparative analysis of the results of treatment of 108 patients hospitalized in the Branch of the MC JSC “Admiralteyskie Verfi” aged 18 to 60 years (58 men and 50 women) with a diagnosis of acute dorsalgia of cervical localization (M54.2 according to ICD-10). The average age of patients is 42.5 ± 11.1 years.Results. As a result of the clinical and neurological study and statistical processing of the data obtained, it was found that the use of Movalis in the treatment of patients with acute neck pain was more effective compared to the use of generic (Amelotex). In the Movalis group, the level of pain intensity and the index of disability after treatment was significantly lower than in the Amelotex group at an equivalent dose of 15 mg per day (p < 0.01). The analgesic effect in the group of patients receiving Movalis was longer. There was a significant decrease in sleep disorders associated with pain syndrome in the group (Movalis) compared with patients of the second group (Amelotex). Conclusions. The absence of therapeutic bioequivalence between Movalis and Amelotex revealed in our study determines the relevance of the choice of drugs for the complex therapy of patients of this profile. A multimodal approach to the strategy of treating neck pain, individually patient-oriented, including the use of effective and safe medicines, physical exercises, manual therapy, is optimal.>< 0.01). The analgesic effect in the group of patients receiving Movalis was longer. There was a significant decrease in sleep disorders associated with pain syndrome in the group (Movalis) compared with patients of the second group (Amelotex).Conclusions. The absence of therapeutic bioequivalence between Movalis and Amelotex revealed in our study determines the relevance of the choice of drugs for the complex therapy of patients of this profile. A multimodal approach to the strategy of treating neck pain, individually patient-oriented, including the use of effective and safe medicines, physical exercises, manual therapy, is optimal.

PREVALENCE OF CHRONIC NON-SPECIFIC MUSCULOSKELETAL PAIN IN HOUSEHOLD FEMALES, AND ITS IMPACT ON THEIR QUALITY OF LIFE

BACKGROUND AND AIM One of the most intractable clinical problems clinicians face is chronic musculoskeletal pain. The study aimed to determine the prevalence, nature, and treatment of chronic non-specific musculoskeletal regional pain among household females. METHODOLOGY In a descriptive cross-sectional study, 1100 participants aged 30-45 years were interviewed. Purposive sampling technique and Face to face interview method were integrated for data collection. The respondents were females who suffered from musculoskeletal pain >6 months and experienced pain many times during the last month. Participants who suffered from musculoskeletal pain associated with malignancy or systemic pathologies were excluded from the study. A structured questionnaire was designed that included a Modified SF-36 scale to determine the quality of life and a visual analogue scale to measure pain intensity. RESULTS Prevalence of chronic Knee pain was 34.5%, low Back 31.4%, neck 20.4%, and shoulder pain was13.7%. The intensity of back pain was (2.94±.43), knee (3.01±.54), neck (2.62±.58), and shoulder pain (2.76±.57). Only 21% of females were on prescribed treatment by Pain management specialists, and the rest were relayed on non-prescribed remedies. CONCLUSION Musculoskeletal Chronic pain of moderate to severe intensity was more prevalent in the knee joint among household females. Both back and knee pain seriously affect the quality of their physical and social life. KEYWORDS: knee, low back, neck, shoulder, pain, quality of life.

Physical activity in patients with nonspecific low back painin therapy

Introduction. Kinesitherapy (KT) – one of the leading areas of patient care with chronic nonspecific (musculoskeletal pain) low back pain. For chronic lumbar pain, a standard KT is commonly used, that includes group sessions with a medical specialist. Often not taking into account the individual characteristics of patients, their attitude to KT, does not use a backpain education program in combination with KT (extended KT). Physical activity and hypodynamia are compared in patients with chronic nonspecificlow back pain in standard KT and extended KT.Aim of study is to assess the effectiveness of the standard and extended KT in the enhancement of physical activity.Materials and methods. 71 patients were observed (17 men and 54 women, average age 55.09 ± 13 years) with chronic nonspecific low back pain. Patients received non-steroidal anti-inflammatory drugs (NSAIDs) as painkillers. 34 patients received a standard KT, 37 patients – an extended KT. Patients were asked to complete the Numeric Pain Rating Scale (NPRS), the Oswestry Low Back Pain Disability Questionnaire, and the International Physical Activity Questionnaire (IPAQ) at baseline, after 7 days and 90 days.Results and discussion. In the extended KT group, physical activity increased from 11 (7–16) points to 16 (13–19) points after 7 days (p = 0.001) and up to 23 (15–26) points after 3 months (p = 0.0002). There has been a statistically significant decrease in the proportion of patients with hypodynamy (p = 0.0015). There is no statistically significant increase in physical activity in the standard therapy group. The use of NSAIDs in non-specific low back pain is discussed, the effectiveness of the use of dexketoprofen (Dexalgin) during lumbar pain is noted.Conclusion. In the case of nonspecific low back pain, the extended KTimprovesphysical activity and reduce hypodynamy.