Pharmacotherapy of chronic back pain: Are there prospects?

Treatment for chronic back pain (CBP) is a complex therapeutic challenge. The heterogeneity of the disease, different phenotypes of pain, comorbidities, and individual sensitivity to drugs require the use of a broad-spectrum of analgesics with different mechanisms of action. The present review brief...

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Main Authors: G. I. Shvartsman, A. E. Karateev
Format: Article
Language:Russian
Published: IMA-PRESS LLC 2017-09-01
Series:Современная ревматология
Subjects:
Online Access:https://mrj.ima-press.net/mrj/article/view/784
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author G. I. Shvartsman
A. E. Karateev
author_facet G. I. Shvartsman
A. E. Karateev
author_sort G. I. Shvartsman
collection DOAJ
description Treatment for chronic back pain (CBP) is a complex therapeutic challenge. The heterogeneity of the disease, different phenotypes of pain, comorbidities, and individual sensitivity to drugs require the use of a broad-spectrum of analgesics with different mechanisms of action. The present review briefly considers the evidence base of basic pharmacological groups that are used for the treatment of CBP in real clinical practice or in clinical trials: nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, tumor necrosis factor-α (TNF-α) inhibitors, nerve growth factor inhibitors, opioids, antidepressants, and muscle relaxants, as well as antibiotic therapy. It is shown that at the moment there are no existing or promising drugs that are able to completely solve the problem of CBP. Treatment should be initiated with NSAIDs. Although their efficacy in CBP is relatively low; nevertheless, the use of NSAIDs makes it possible to achieve a certain reduction in pain and to create conditions for the successful use of other drug classes and non-drug methods. The benefits of nimesulide that may be deemed to be a first-line drug among NSAIDs are considered in terms of its efficacy, relative safety, and availability.
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series Современная ревматология
spelling doaj-art-c2172633abb64462ada109243ade0f4a2025-08-20T03:01:22ZrusIMA-PRESS LLCСовременная ревматология1996-70122310-158X2017-09-0111311212010.14412/1996-7012-2017-3-112-1202057Pharmacotherapy of chronic back pain: Are there prospects?G. I. Shvartsman0A. E. Karateev1I.I. Mechnikov North-West State Medical University, Ministry of Health of RussiaV.A. Nasonova Research Institute of RheumatologyTreatment for chronic back pain (CBP) is a complex therapeutic challenge. The heterogeneity of the disease, different phenotypes of pain, comorbidities, and individual sensitivity to drugs require the use of a broad-spectrum of analgesics with different mechanisms of action. The present review briefly considers the evidence base of basic pharmacological groups that are used for the treatment of CBP in real clinical practice or in clinical trials: nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, tumor necrosis factor-α (TNF-α) inhibitors, nerve growth factor inhibitors, opioids, antidepressants, and muscle relaxants, as well as antibiotic therapy. It is shown that at the moment there are no existing or promising drugs that are able to completely solve the problem of CBP. Treatment should be initiated with NSAIDs. Although their efficacy in CBP is relatively low; nevertheless, the use of NSAIDs makes it possible to achieve a certain reduction in pain and to create conditions for the successful use of other drug classes and non-drug methods. The benefits of nimesulide that may be deemed to be a first-line drug among NSAIDs are considered in terms of its efficacy, relative safety, and availability.https://mrj.ima-press.net/mrj/article/view/784chronic back painpharmacotherapynonsteroidal anti-inflammatory drugsglucocorticoidsbiological agentsnerve growth factor inhibitorsopioidsantidepressantsmuscle relaxantsantibiotic therapy
spellingShingle G. I. Shvartsman
A. E. Karateev
Pharmacotherapy of chronic back pain: Are there prospects?
Современная ревматология
chronic back pain
pharmacotherapy
nonsteroidal anti-inflammatory drugs
glucocorticoids
biological agents
nerve growth factor inhibitors
opioids
antidepressants
muscle relaxants
antibiotic therapy
title Pharmacotherapy of chronic back pain: Are there prospects?
title_full Pharmacotherapy of chronic back pain: Are there prospects?
title_fullStr Pharmacotherapy of chronic back pain: Are there prospects?
title_full_unstemmed Pharmacotherapy of chronic back pain: Are there prospects?
title_short Pharmacotherapy of chronic back pain: Are there prospects?
title_sort pharmacotherapy of chronic back pain are there prospects
topic chronic back pain
pharmacotherapy
nonsteroidal anti-inflammatory drugs
glucocorticoids
biological agents
nerve growth factor inhibitors
opioids
antidepressants
muscle relaxants
antibiotic therapy
url https://mrj.ima-press.net/mrj/article/view/784
work_keys_str_mv AT gishvartsman pharmacotherapyofchronicbackpainarethereprospects
AT aekarateev pharmacotherapyofchronicbackpainarethereprospects