Patient with discogenic radiculopathy: diagnostic and treatment algorithms

Abstract

Low back pain is one of the most common causes of seeking medical care, loss of ability to work, and is a heavy socio-economic burden for the country. In the vast majority of cases, the pain syndrome is musculoskeletal, associated with pathology of joints, muscles and ligaments and is benign in nature. Discogenic compression-ischemic radiculopathy is less common, but this pathology is associated with a wide range of issues in differential diagnosis and correct treatment tactics for patients. This article provides an overview of modern clinical guidelines for the diagnosis and treatment of discogenic radiculopathies. The diagnosis of discogenic radiculopathy is clinical. MRI of the spine is performed to exclude secondary causes of nerve root compression if treatment is ineffective. An important direction in the treatment of radiculopathy is non-drug treatment, which includes informing the patient about the benign nature of the disease, the possibility of spontaneous regression of a disc herniation, therapeutic exercises, maintaining the maximum tolerated amount of physical activity, social and professional activity Treatment of back pain is associated with an increased risk of side effects of non-steroidal anti-inflammatory drugs, which patients often use uncontrollably. The issue of safe relief of pain syndromes remains relevant. This can be achieved using a combination of non-steroidal anti-inflammatory drugs and high-dose B vitamins. B vitamins also have a neurotrophic effect, which allows the restoration of impaired neurological functions.