Lumbosacral dorsopathies: modern aspects of diagnosis and pharmacological treatment

Abstract

Lumbosacral dorsopathy is the most common diagnosis in patients with lower back pain. Issues of conservative treatment of lumbosacral dorsopathies are considered based on the analysis of scientific materials contained in large databases such as PubMed, Cochrane library, MEDLINE, and eLibrary. From all publications, 40 of the most relevant works were selected and considered in detail, and key figures and short conclusions for each work are displayed in a table. Symptoms of lumbosacral dorsopathies often have an extremely negative effect on the patients ability to work and quality of life; therefore, effective and prompt treatment is important. Given the complex and multifactorial pathogenesis and multitudes of options for lumbosacral dorsopathies, conservative treatment should be complex and individualized, and drugs should have a high safety profile, especially those used in the treatment of chronic diseases. These requirements are met by some nonsteroidal anti-inflammatory drugs and co-analgesics, such as chondroprotectors and B vitamins. For the treatment of acute and exacerbated lumbosacral dorsopathies, the local use of hormonal drugs, anticonvulsants, antidepressants, muscle relaxants, etc., is possible, while treatment dosage and duration should be strictly limited. The local use of hormonal drugs and hodroprotectors such as therapeutic and diagnostic blockades is justified in the absence of contraindications and availability of opportunities, which helps reduce the likelihood of systemic adverse reactions and provides greater bioavailability.