The role of correction of androgen deficiency in the treatment of nonspecific chronic back pain in men


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Abstract

Background. The optimal management of patients with chronic pain is one of the priorities of modern medicine. In order to improve the quality and effectiveness of pain management, the tactics of an individual approach in pain medicine, including taking into account differences in the level of sex hormones, is required. Objective. Evaluation of the role of sex hormones (testosterone and chorionic gonadotropin drugs) in the pain management in male patients with androgen deficiency and concomitant nonspecific chronic back pain. Methods. 68 male patients were examined during visit an urologist and an endocrinologist. The study duration is 2015-2017. The study included 2 stages: 1) evaluation of the structure of pain syndromes in male patients during visiting an urologist and an endocrinologist; 2) assesment of the possible effect of increase in patient’s blood total testosterone level on the level of pain and other clinical indicators with the use of testosterone and/or chorionic gonadotropin preparations. Results. The prevalence of pain syndromes among male patients was 66%. The structure of pain syndromes was represented by headache in 24% of patients; back pain in 20% of patients; joint pain in 14% of patients; and muscle pain in 8% of patients. Correction of androgen deficiency in male patients with concomitant nonspecific chronic back pain statistically significantly reduced the pain severity, the degree of daily living activity impairment, the level of depression and situational anxiety. The most favorable target blood total testosterone level in male patients, corresponding to the absence or minimal pain complaints, was ≥ 22.0 nmol/L. Conclusion. The results suggest that the practical use of drugs that increase blood testosterone level (testosterone and/or human chorionic gonadotrophins) to optimize the pain management in male patients with androgen deficiency and associated nonspecific chronic back pain is promising.

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About the authors

Roman R. Ilyasov

Sechenov First Moscow State Medical University (Sechenov University)

Email: romamma@mail.ru
Department of Nervous Diseases IPGE

A. B Danilov

Sechenov First Moscow State Medical University (Sechenov University)

S. Yu Kalinchenko

Peoples' Friendship University of Russia

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