Resolution of the Council of Experts on the Treatment of Radiculopathy “New approaches to the treatment of back pain”

On November 08, 2024 in Moscow, under the auspices of the Russian Society for the Study of Pain (RSSP), a Council of Experts was held, during which leading specialists in the field of neurology, who have a high level of expertise in the treatment of back pain, discussed modern approaches to the therapy of discogenic lumbosacral radiculopathy (DLSR). The Council actualized the leading pathogenetic mechanisms of the disease onset and progression; discussed the mechanisms of pathogenesis, which are currently still insufficiently affected by pharmacotherapeutic intervention. Conservative therapy of DLSR is effective and allows to avoid surgical treatment in the majority (more than 90%) of cases. The leading role in conservative therapy of DLSR is played by informing the patient about the benign nature of DLSR, the possibility of spontaneous regression of disc herniation, methods of kinesiotherapy under the supervision of a specialist, epidural administration of local anesthetics and glucocorticoids in the acute period of the disease. In real practice, non-steroidal anti-inflammatory drugs, anticonvulsants are widely used, but their effectiveness remains controversial, so the search for new methods of conservative therapy is relevant. The experts noted the importance of the approach to the treatment of the problem under consideration from the position of its pathogenesis and discussed the introduction of new groups of drugs, emphasizing the need to expand clinical recommendations in favor of drugs with pathogenetically justified and complex mechanisms of action in back pain. The results of RCTs and the experience of clinical application of parenteral preparation of triterpene saponin escin — L-lysine escinate in different groups of patients with DLSR were discussed in detail. The expediency of conducting a multicenter placebo-controlled study of the efficacy of escin — L-lysine escinate in acute DLSR was noted.

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Publication Details

Journal
Russian Journal of Pain
Published
2025-03-13
DOI
https://doi.org/10.17116/pain20252301184
Primary Topic
Spine and Intervertebral Disc Pathology
Type
article
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article

Resolution of the Council of Experts on the Treatment of Radiculopathy “New approaches to the treatment of back pain”

Е.А. Антипенко, Maxim V. Churyukanov, O. B. Doronina, Ф. И. Девликамова et al.
Russian Journal of Pain
Spine and Intervertebral Disc Pathology
article

Resolution of the Council of Experts on the Treatment of Radiculopathy “New approaches to the treatment of back pain”

Е.А. Антипенко, Maxim V. Churyukanov, O. B. Doronina, Ф. И. Девликамова, Olga V. Kurushina, D. A. Iskra, О.С. Давыдов, В. А. Парфенов, Е. Р. Баранцевич, И А Щукин, Mikhail Lvovich Kukushkin, P.P. Kalinsky, T. L. Vizilo, Yu. N. Bykov, V.A. Shirokov, Fedin Ai, Yu. V. Karakulova, А. Е. Барулин, E.V. Parkhomenko, А. В. Амелин, Ф. А. Хабиров, М. И. Карпова, С. М. Карпов, L. L. Korsunskaya, Н. В. Исаева
article en

Abstract

On November 08, 2024 in Moscow, under the auspices of the Russian Society for the Study of Pain (RSSP), a Council of Experts was held, during which leading specialists in the field of neurology, who have a high level of expertise in the treatment of back pain, discussed modern approaches to the therapy of discogenic lumbosacral radiculopathy (DLSR). The Council actualized the leading pathogenetic mechanisms of the disease onset and progression; discussed the mechanisms of pathogenesis, which are currently still insufficiently affected by pharmacotherapeutic intervention. Conservative therapy of DLSR is effective and allows to avoid surgical treatment in the majority (more than 90%) of cases. The leading role in conservative therapy of DLSR is played by informing the patient about the benign nature of DLSR, the possibility of spontaneous regression of disc herniation, methods of kinesiotherapy under the supervision of a specialist, epidural administration of local anesthetics and glucocorticoids in the acute period of the disease. In real practice, non-steroidal anti-inflammatory drugs, anticonvulsants are widely used, but their effectiveness remains controversial, so the search for new methods of conservative therapy is relevant. The experts noted the importance of the approach to the treatment of the problem under consideration from the position of its pathogenesis and discussed the introduction of new groups of drugs, emphasizing the need to expand clinical recommendations in favor of drugs with pathogenetically justified and complex mechanisms of action in back pain. The results of RCTs and the experience of clinical application of parenteral preparation of triterpene saponin escin — L-lysine escinate in different groups of patients with DLSR were discussed in detail. The expediency of conducting a multicenter placebo-controlled study of the efficacy of escin — L-lysine escinate in acute DLSR was noted.

Russian Journal of PainVol. 23(1)
Privolzhsky Research Medical University (RU), Altai State Medical University (RU), Novosibirsk State Medical University (RU), Volgograd State Medical University (RU), Sechenov University (RU), Vladivostok State Medical University (RU), First Pavlov State Medical University of St. Petersburg (RU), Chelyabinsk State Medical Academy (RU), Pirogov Russian National Research Medical University (RU), Perm State Medical Academy (RU), Krasnoyarsk State Medical University (RU), Ural State Medical University (RU), Kemerovo State Medical University (RU), Kazan State Medical Academy (RU), Research Institute of General Pathology and Pathophysiology, the Russian Academy of Medical Sciences (RU), V.I. Vernadsky Crimean Federal University (UA), Irkutsk State Medical University (RU), Saint Petersburg State Pediatric Medical University (RU)
Openalex Percentile: Top 94%
Spine and Intervertebral Disc Pathology
DOISourceOpenAlex
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