Management of patients with chronic low back pain in outpatient practice: a clinical observation

Back pain is one of the most common reasons for visits to the doctor and temporary disability. In non-specific chronic low back pain (CLBP) most effective approach is a complex (multidisciplinary) approach, aimed at relieving pain and improving the quality of life by using an educational program, kinesiotherapy, psychological methods and optimization of drug therapy. We present the observation of a 48-year-old patient with CLBP whose treatment was ineffective during one year. The patient was repeatedly prescribed medications, and the methods of magnetotherapy, massage, phonophoresis with hydrocortisone. Educational program, kinesiotherapy and psychological methods were not applied. The examination of the patient revealed emotional disorders, misconceptions about the disease and a pronounced functional impairment due to pain. The application of a complex therapy, which included an educational program, individual kinesiotherapy, psychological methods, Dexalgin as a non-steroidal anti-inflammatory drug, led to a significant reduction in pain after 7 days and a complete regression of symptoms after 2 months. The issues of efficacy and safety of the use of Dexalgin and the possibility of introducing the complex approach into the clinical practice of management of patients with chronic back pain are discussed.