Discogenic lumbosacral radiculopathy. Recommendations of the Russian Association for the Study of Pain (RSSP)
When examining a patient with lumbosacral pain, it is necessary to rule out the specific cause of the disease. The diagnosis of discogenic lumbosacral radiculopathy (DLSR) is based on clinical examination; magnetic resonance imaging (MRI) is of informative value in excluding other causes of radiculo...
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IMA-PRESS LLC
2020-08-01
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| Series: | Неврология, нейропсихиатрия, психосоматика |
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| author | V. A. Parfenov N. N. Yakhno O. S. Davydov M. L. Kukushkin M. V. Churyukanov V. A. Golovacheva G. Yu. Evzikov A. I. Isaikin M. A. Ivanova A. E. Karateev A. V. Amelin E. E. Achkasov L. R. Akhmadeeva M. A. Bakhtadze E. R. Barantsevich A. E. Barulin A. N. Belova G. N. Belskaya V. G. Bychenko O. B. Doronina O. N. Dreval O. I. Zagorulko E. D. Isagulyan D. A. Iskra P. P. Kalinsky Yu. V. Karakulova O. V. Kurushina L. A. Medvedeva D. M. Merkulova A. P. Rachin D. A. Sergienko I. A. Strokov F. A. Khabirov V. A. Shirokov E. Z. Yakupov |
| author_facet | V. A. Parfenov N. N. Yakhno O. S. Davydov M. L. Kukushkin M. V. Churyukanov V. A. Golovacheva G. Yu. Evzikov A. I. Isaikin M. A. Ivanova A. E. Karateev A. V. Amelin E. E. Achkasov L. R. Akhmadeeva M. A. Bakhtadze E. R. Barantsevich A. E. Barulin A. N. Belova G. N. Belskaya V. G. Bychenko O. B. Doronina O. N. Dreval O. I. Zagorulko E. D. Isagulyan D. A. Iskra P. P. Kalinsky Yu. V. Karakulova O. V. Kurushina L. A. Medvedeva D. M. Merkulova A. P. Rachin D. A. Sergienko I. A. Strokov F. A. Khabirov V. A. Shirokov E. Z. Yakupov |
| author_sort | V. A. Parfenov |
| collection | DOAJ |
| description | When examining a patient with lumbosacral pain, it is necessary to rule out the specific cause of the disease. The diagnosis of discogenic lumbosacral radiculopathy (DLSR) is based on clinical examination; magnetic resonance imaging (MRI) is of informative value in excluding other causes of radiculopathy and in evaluating disk herniation. If the signs of cauda equina and spinal cord compression are absent, and no epidural glucocorticoid injection or urgent surgical treatment is scheduled, there is no reason for early (within the first 4 weeks) MRI.It is recommended to inform the patient with DLSR about the possibility of disk herniation regression and natural recovery and about the advisability of maintaining physical activity. Epidural administration of local anesthetics and glucocorticoids and use of non-steroidal anti-inflammatory drugs are advisable to relieve acute pain. Anticonvulsants (pregabalin and gabapentin), muscle relaxants, and B vitamins can be used as additional methods for acute DLSR; psychological therapies (cognitive behavioral therapy), antidepressants, therapeutic exercises (kinesiotherapy), manual therapy, and acupuncture are effective in chronic DLSR. Consultation with a neurosurgeon for possible microdiscectomy is indicated in the presence of cauda equina syndrome (urgently) and in the absence of medical therapy effects within 4–8 weeks.Therapeutic exercises (kinesitherapy) with an educational program for prevention of strenuous physical activity and static and uncomfortable positions for a long time, as well as for teaching how to lift weights properly, etc. are recommended for preventive purposes. |
| first_indexed | 2024-04-10T02:00:38Z |
| format | Article |
| id | doaj.art-335cf51f140e457ebf57a1a61adb9f32 |
| institution | Directory Open Access Journal |
| issn | 2074-2711 2310-1342 |
| language | Russian |
| last_indexed | 2024-04-10T02:00:38Z |
| publishDate | 2020-08-01 |
| publisher | IMA-PRESS LLC |
| record_format | Article |
| series | Неврология, нейропсихиатрия, психосоматика |
| spelling | doaj.art-335cf51f140e457ebf57a1a61adb9f322023-03-13T08:42:20ZrusIMA-PRESS LLCНеврология, нейропсихиатрия, психосоматика2074-27112310-13422020-08-01124152410.14412/2074-2711-2020-4-15-241021Discogenic lumbosacral radiculopathy. Recommendations of the Russian Association for the Study of Pain (RSSP)V. A. Parfenov0N. N. Yakhno1O. S. Davydov2M. L. Kukushkin3M. V. Churyukanov4V. A. Golovacheva5G. Yu. Evzikov6A. I. Isaikin7M. A. Ivanova8A. E. Karateev9A. V. Amelin10E. E. Achkasov11L. R. Akhmadeeva12M. A. Bakhtadze13E. R. Barantsevich14A. E. Barulin15A. N. Belova16G. N. Belskaya17V. G. Bychenko18O. B. Doronina19O. N. Dreval20O. I. Zagorulko21E. D. Isagulyan22D. A. Iskra23P. P. Kalinsky24Yu. V. Karakulova25O. V. Kurushina26L. A. Medvedeva27D. M. Merkulova28A. P. Rachin29D. A. Sergienko30I. A. Strokov31F. A. Khabirov32V. A. Shirokov33E. Z. Yakupov34I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaResearch Institute for General Pathology and PathophysiologyResearch Institute for General Pathology and PathophysiologyI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia; Academician B.V. Petrovsky Russian Research Center of SurgeryI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaV.A. Nasonova Research Institute of RheumatologyAcademician I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of RussiaI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaBashkir State Medical University, Ministry of Health of RussiaN.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaAcademician I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of RussiaVolgograd State Medical University, Ministry of Health of RussiaVolga Research Medical University, Ministry of Health of RussiaResearch Center of Neurology, Ministry of Education and Science of RussiaAcademician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of RussiaNovosibirsk State Medical University, Ministry of Health of RussiaRussian Medical Academy of Continuing Professional Education, Ministry of Health of RussiaAcademician B.V. Petrovsky Russian Research Center of SurgeryAcademician N.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of RussiaSaint Petersburg State Pediatric Medical University, Ministry of Health of RussiaPacific State Medical University, Ministry of Health of RussiaAcademician E.A. Vagner Perm State Medical University, Ministry of Health of RussiaVolgograd State Medical University, Ministry of Health of RussiaAcademician B.V. Petrovsky Russian Research Center of SurgeryB.M. Gekht Neurology CenterNational Medical Research Center for Rehabilitation and Balneology, Ministry of Health of RussiaSouth Ural State Medical University, Ministry of Health of RussiaI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaKazan State Medical Academy, Branch, Russian Medical Academy of Continuing Professional Education, Ministry of Health of RussiaResearch and Production Unit, Neurology Clinic, Yekaterinburg Medical Research Center for Prophylaxis and Health Protection in Industrial Workers; Ural State Medical University, Ministry of Health of RussiaKazan State Medical University, Ministry of Health of RussiaWhen examining a patient with lumbosacral pain, it is necessary to rule out the specific cause of the disease. The diagnosis of discogenic lumbosacral radiculopathy (DLSR) is based on clinical examination; magnetic resonance imaging (MRI) is of informative value in excluding other causes of radiculopathy and in evaluating disk herniation. If the signs of cauda equina and spinal cord compression are absent, and no epidural glucocorticoid injection or urgent surgical treatment is scheduled, there is no reason for early (within the first 4 weeks) MRI.It is recommended to inform the patient with DLSR about the possibility of disk herniation regression and natural recovery and about the advisability of maintaining physical activity. Epidural administration of local anesthetics and glucocorticoids and use of non-steroidal anti-inflammatory drugs are advisable to relieve acute pain. Anticonvulsants (pregabalin and gabapentin), muscle relaxants, and B vitamins can be used as additional methods for acute DLSR; psychological therapies (cognitive behavioral therapy), antidepressants, therapeutic exercises (kinesiotherapy), manual therapy, and acupuncture are effective in chronic DLSR. Consultation with a neurosurgeon for possible microdiscectomy is indicated in the presence of cauda equina syndrome (urgently) and in the absence of medical therapy effects within 4–8 weeks.Therapeutic exercises (kinesitherapy) with an educational program for prevention of strenuous physical activity and static and uncomfortable positions for a long time, as well as for teaching how to lift weights properly, etc. are recommended for preventive purposes.https://nnp.ima-press.net/nnp/article/view/1405discogenic lumbosacral radiculopathyepidural glucocorticoid injectionnonsteroidal anti-inflammatory drugsantiepileptic drugstherapeutic exercisesmicrodiscectomymanual therapycauda equina syndromedisk herniation regression |
| spellingShingle | V. A. Parfenov N. N. Yakhno O. S. Davydov M. L. Kukushkin M. V. Churyukanov V. A. Golovacheva G. Yu. Evzikov A. I. Isaikin M. A. Ivanova A. E. Karateev A. V. Amelin E. E. Achkasov L. R. Akhmadeeva M. A. Bakhtadze E. R. Barantsevich A. E. Barulin A. N. Belova G. N. Belskaya V. G. Bychenko O. B. Doronina O. N. Dreval O. I. Zagorulko E. D. Isagulyan D. A. Iskra P. P. Kalinsky Yu. V. Karakulova O. V. Kurushina L. A. Medvedeva D. M. Merkulova A. P. Rachin D. A. Sergienko I. A. Strokov F. A. Khabirov V. A. Shirokov E. Z. Yakupov Discogenic lumbosacral radiculopathy. Recommendations of the Russian Association for the Study of Pain (RSSP) Неврология, нейропсихиатрия, психосоматика discogenic lumbosacral radiculopathy epidural glucocorticoid injection nonsteroidal anti-inflammatory drugs antiepileptic drugs therapeutic exercises microdiscectomy manual therapy cauda equina syndrome disk herniation regression |
| title | Discogenic lumbosacral radiculopathy. Recommendations of the Russian Association for the Study of Pain (RSSP) |
| title_full | Discogenic lumbosacral radiculopathy. Recommendations of the Russian Association for the Study of Pain (RSSP) |
| title_fullStr | Discogenic lumbosacral radiculopathy. Recommendations of the Russian Association for the Study of Pain (RSSP) |
| title_full_unstemmed | Discogenic lumbosacral radiculopathy. Recommendations of the Russian Association for the Study of Pain (RSSP) |
| title_short | Discogenic lumbosacral radiculopathy. Recommendations of the Russian Association for the Study of Pain (RSSP) |
| title_sort | discogenic lumbosacral radiculopathy recommendations of the russian association for the study of pain rssp |
| topic | discogenic lumbosacral radiculopathy epidural glucocorticoid injection nonsteroidal anti-inflammatory drugs antiepileptic drugs therapeutic exercises microdiscectomy manual therapy cauda equina syndrome disk herniation regression |
| url | https://nnp.ima-press.net/nnp/article/view/1405 |
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