Cognitive functional therapy and non-steroidal anti-inflammatory drugs in the treatment of low back pain

Abstract

A multidisciplinary  approach  including  drug and non-drug  methods is recommended for the  treatment of chronic low back pain (CLBP). Kinesiotherapy, psychological  methods, and nonsteroidal anti-inflammatory drugs (NSAIDs) have been  shown to be highly effective  for CLBP. All of the listed  methods contribute to significant  relief and relief of pain, increase  the patient’s social and physical activity, and improve the emotional state. Psychological  methods help patients cope with catastrophizing pain, increase  daily activities, and  reduce  the  likelihood  of disease  recurrence.  Results  from clinical studies  and  systematic reviews demonstrate the effectiveness of psychological  techniques such as cognitive  behavioral  therapy  (CBT) and mindfulness  therapy  (mindfulness)  in the  treatment of CLBP. Cognitive Functional  Therapy (CFT) is a promising  new psychological method  that was created  on the basis of CPT. Clinical studies  have been conducted confirming the efficacy of CFT in CLBP. CFT is aimed at regular therapeutic exercises, normalization of motor activity with avoidance  of excessive  physical and static exertion, avoidance  of sedentary lifestyle  and normalization of sleep, which is often  disturbed  in chronic back pain. In practice, patients with CLBP often  have low adherence to increased physical activity during the day, to therapeutic exercises. In most cases, this is due to the fact that in the first days of increased physical activity there  is an increase  in pain. Patients mistakenly fear further  progression of pain and disease. Prescribing  NSAIDs usually results  in pain reduction  as early as the first days of administration, so patients with chronic musculoskeletal pain have an increased desire  to engage in physical activity and therapeutic exercises. The choice of a particular NSAID medication is made individually, taking into account the co-morbidities and the risk of possible  side effects. We discuss the use of nimesulide in CLBP.