Errors and optimization of management of patients with chronic lumbalgia: Discussion based on the clinical observation

Chronic nonspecific low back pain (chronic lumbalgia) is one of the most common causes of disability in the adult population. Currently, effectivemethods of treatment of chronic nonspecific lumbalgia have been proposed, which include an educational program, kinesiotherapy, psychologicalmethods of treatment and optimization of drugtherapy. However, these methods are not often used in real clinical practice, which reflects the observation of a 52-year-old patient who had no positive effect from therapy for 6 months. According to the MRI data, the patient had herniated discs at the level of the lower lumbar discs, with which the patient associated a persistent pain effect. However, the examination revealed signs of damage to the facet joints and sacroiliac joint, which were of leading importance as an anatomical cause of pain. The patient also had emotional disorders, the phenomenon of catastrophization, and painful behavior. An educational conversation was held with the patient, therapeutic exercises were selected, Novema in the afternoon and Novema Night in the evening were prescribed as a non-steroidal anti-inflammatory drug. After 7 days, the pain decreased significantly, sleep improved, adherence to therapeutic gymnastics increased, after 1.5 months the pain syndrome regressed, the patient became active as before the disease. The issues of optimizing the management of patients with chronic lumbalgia and the possibility of widespread implementation of an integrated approach in clinical practice are discussed.