Chronic non-specific low back pain in combination with tension-type headache, issues of therapy optimization

We describe a clinical case of a successful treatment of a 46-year-old female patient with chronic musculoskeletal low back pain combined with a tension-type headache, who did not observe the effect of various methods of therapy. A comprehensive approach to the patient's care was applied, targeting the factors of pain chronification, comorbid disorders, an increase in daily physical activity and improvement of quality of life. It is shown how the formation of the patient's correct perception about the causes and factors contributing to the pain, lifestyle correction (avoidance of low physical activity, prolonged static postures during the day) in combination with individual kinesiotherapy and optimal pharmacotherapy with the drug Nimesil (nimesulide) made it possible to reduce the pain relatively quickly and steadily, normalize sleep and mood. The drug of choice was Nimesil (nimesulide) – a non-steroidal anti-inflammatory drug that is widely used in Russian neurological practice and has proven to be effective and safe in the treatment of musculoskeletal pain. Of great importance in the patient's treatment was kinesiotherapy, which included therapeutic exercises, training of the correct postures and recommendations on ergonomics and lifestyle. It is important to mention that all components of the complex therapy were prescribed simultaneously from the first days of treatment, so that comprehensive treatment made it possible to achieve a short and long-term effect relatively quickly (6 month follow-up), while the earlier treatment without an integrative approach did not have a lasting clinical effect. The issues of optimizing of treatment of patients with chronic musculoskeletal pain are discussed.