Diagnosis and treatment of a patient with back pain

Prof. Korzh O.M.1, PHD Korzh I.V.2

1-Kharkiv Medical Academy of Postgraduate Education, Ukraine

2-Institute of Spine and Joint Pathology, Academy of Medical Sciences of Ukraine

 Back pain due to socio-economic losses in recent years has become a leading cause of disability, therefore the especially urgent problem of rapid effective pain relief and rehabilitation of this large group of patients. Despite the keen interest in this problem and the success achieved in the management of patients, the pathogenetic multifaceted pain syndrome is often a «stumbling block» to form an adequate therapeutic program. Treatment of back pain requires a multidisciplinary approach. Nonsteroidal anti-inflammatory drugs are the «gold standard» for the treatment of nonspecific back pain due to its ability to influence pain impulsion at all levels of afferent transmission from peripheral nociceptors to sensitive brain centers.

Key Words: back pain, diagnostics, treatment, non-steroidal anti-inflammatory drugs.



For citing:

1.Корж, О.М. Діагностика та лікування пацієнта з болем у спині / О.М. Корж, І.В. Корж // Східноєвропейський журнал внутрішньої та сімейної медицини. – 2020. – № 1. – С. 13-17. doi: 10.15407/internalmed2020.01.013.

2.Korzh OM, Korzh IV. [Diagnosis and treatment of a patient with back pain]. Shidnoevr. z. vnutr. simejnoi med. 2020;1:13-17. doi: 10.15407/internalmed2020.01.013.


1. Vardeh D, Mannion RJ, Woolf CJ. Toward a Mechanism-Based Approach to Pain Diagnosis. The Journal of Pain. 2016;17(9):50-69. https://doi.org/10.1016/j.jpain.2016.03.001
2. Woolf CJ. Pain: Moving from Symptom Control toward Mechanism-ф Pharmacologic Management. Ann. Intern. Med. 2004;140(6):441- 451. https://doi.org/10.7326/0003-4819-140-8-200404200-00010.
3. Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. The Lancet. 2012;379(9814):482-491. https://doi.org/10.1016/S0140-6736(11)60610-7.
4. Casser HR, Seddigh S, Rauschmann M. Acute Lumbar Back Pain: Investigation, Differential Diagnosis, and Treatment. Deutsches Aerzteblatt. 2016;113(13):223-234. https://doi.org/10.3238/arztebl.2016.0223.
5. Treede RD. The International Association for the Study of Pain definition of pain: as valid in 2018 as in 1979, but in need of regularly updated footnotes. Pain Rep. 2018;3(2):e643. https://doi.org/10.1097/pr9.0000000000000643.
6. Chenot JF, Greitemann B, Kladny B, Petzke F, Pfingsten M, Schorr SG. Non-Specific Low Back Pain. Deutsches Aerzteblatt Online. 2017;114(51- 52):883-890. https://doi.org/10.3238/arztebl.2017.0883.
7. Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, Woolf A, Vos T, Buchbinder R. A Systematic Review of the Global Prevalence of Low Back Pain. Arthritis & Rheumatism. 2012;64(6):2028-2037. https://doi.org/10.1002/art.34347.
8. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. The Lancet. 2017;389(10070):736-747. https://doi.org/10.1016/s0140-676(16)30970-9.
9. Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. https://doi.org/10.3390/healthcare4020022.
10. Rossignol M, Poitras S, Dionne C, Tousignant M, Truchon M, Arsenault B, Allard P, Coté M, Neveu A. An interdisciplinary guideline development process: the Clinic on Low-back pain in Interdisciplinary Practice (CLIP) low-back pain guidelines. Implementation Science. 2007;2(1):36. https://doi.org/10.1186/1748-5908-2-36.
11. Blyth FM, March LM, Nicholas MK, Cousins MJ. Self-management of chronic pain: a population-based study. Pain. 2005;113(3):285-292. https://doi.org/10.1016/j.pain.2004.12.004
12. Goubert D, Oosterwijck JV, Meeus M, Danneels L. Structural Changes of Lumbar Muscles in Non-Specific Low Back Pain. Pain Physician. 2016,19(7):E985-E1000.
13. Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006;332(7555):1430-1434. https://doi.org/10.1136/bmj.332.7555.1430
14. Khan S, Andrews KL, Jaye PFC-D. Cyclo-Oxygenase (COX) Inhibitors and Cardiovascular Risk: Are Non-Steroidal Anti-Inflammatory Drugs Really Anti-Inflammatory? International Journal of Molecular Sciences. 2019;20(17):4262. https://doi.org/10.3390/ijms20174262.
15. Morton L, Bruin M, Krajewska M, Whibley D, Macfarlane GJ. Beliefs about back pain and pain management behaviours, and their associations in the general population: A systematic review. European Journal of Pain. 2019;23(1):15-30. https://doi.org/10.1002/ejp.1285 .