Cervicobrachialgia and lumboischialgia: A single effective approach to solving the problem

Abstract

The presented clinical case describes a patient with chronic musculoskeletal cervicobrachialgia and lumbosciatica, which are some of the most common neurological disorders. The authors identified the factors contributing to the onset and chronification of musculoskeletal pain: pain catastrophization, anxiety, kinesiophobia, physical inactivity, spending too much time in front of the computer, long-term static postures, comorbid diseases – chronic insomnia, episodic tension-type headache with pericranial tenderness. No therapeutic effect, pain reduction and returning to previous daily activity were earlier observed, the pain chronification factors were not assessed or corrected, no awareness conversations about the causes of the disease and prognosis were held, the patient was only offered pharmacotherapy as treatments, no therapeutic gymnastics was recommended, and no recommendations for ergonomics and motor activities for daily life were provided to the patient. A complex approach to the treatment, including awareness conversations, kinesiotherapy, kinesiotaping, Difendum (diclofenac potassium) therapy course were offered to the patient at the Sechenov University Clinic of Nervous Diseases. Kinesiotherapy is a modern, efficient yet proven method for treating chronic musculoskeletal pain. It includes therapeutic gymnastics, an exercise program for posture correction, recommendations for ergonomics and lifestyle. Difendum (diclofenac potassium) has become a drug of choice within the pharmacotherapy course. It is a non-steroidal anti-inflammatory drug that is widely used in Russian neurological practice and has a proven efficacy and safety profile in the treatment of musculoskeletal pain. It should be noted that Difendum was prescribed to the patient from the first days of treatment at the same time as he started to take a kinesiotherapy training course. The patient experienced a rapid pain relief while taking pharmaceutical therapy, which played an important role in supporting adherence to recommendations for increasing physical activities, ergonomics and therapeutic gymnastics. The complex treatment provided a relatively quick and efficient relief to the patient. After a 5-day course of treatment, he reported a decrease in pain syndrome and an increase in functional activities. After 3 months, the pain completely regressed, sleep and emotional state returned to normal, and daily activities improved. A 6-month follow-up examination showed a persistent therapeutic effect.