Back pain: selection of therapy in terms of effectiveness and safety

Despite the seeming triviality, the task of diagnosing and treating back pain is far from simple: first, it is required to identify the cause of the pain, which does not always lie on the surface, and to exclude a number of conditions that pose a threat to the patient’s health and life; secondly, it is necessary to find an effective treatment. The problem of treating patients with back pain is the frequent chronicity of pain syndrome, which sharply worsens the prognosis of recovery. Timely relief of acute pain and adequate selection of pain relievers can resolve this issue in more than half of patients. The appointment of non-steroidal anti-inflammatory drugs (NSAIDs), which is necessary for acute dorsalgia and is often required in cases of chronic pain, should be carried out taking into account not only the effectiveness, but also the safety of using these drugs individually for each patient. Most elderly patients with concomitant somatic pathology have an average or high risk of developing undesirable side effects with NSAIDs. Among all NSAIDs, coxibs are considered the most selective in terms of their effect on cyclooxygenase-2 and the least toxic in terms of their effect on the gastrointestinal tract. In particular, etoricoxib proved to be an effective drug for the relief of acute and chronic pain, according to international studies and meta-analysis, the risk of negative effects of etoricoxib on the gastrointestinal tract is lower than that of diclofenac and is comparable to the latter in terms of cardiovascular complications. Nevertheless, it is not recommended to use any NSAIDs for a long time, and the selection of the drug should be carried out individually, taking into account the existing concomitant diseases.

pain syndrome, back pain, dorsalgia, nonsteroidal anti-inflammatory drugs, etoricoxib