International Journal of Medical Sciences And Clinical Research
79
https://theusajournals.com/index.php/ijmscr
VOLUME
Vol.05 Issue05 2025
PAGE NO.
79-87
10.37547/ijmscr/Volume05Issue05-17
Effectiveness and Perspectives on The Application of
Traditional Korean And Western Medicine in The
Treatment of Lumbosacral Dorsopathy
Yulduz Isamukhametova
doctoral student of the Department of Rehabilitology, traditional folk medicine and physical education of the Tashkent Medical
Academy, Tashkent, Uzbekistan
Received:
31 March 2025;
Accepted:
29 April 2025;
Published:
31 May 2025
Abstract:
Lumbosacral dorsopathy-related pain syndrome remains a significant global health challenge, requiring
continuous advancement in treatment strategies. While Western medicine provides structured and evidence-
based approaches, traditional Korean medicine offers complementary techniques that may enhance therapeutic
outcomes when used in conjunction. The integration of these two medical systems could lead to more
comprehensive and personalized care for patients. Improving treatment effectiveness is critical, as persistent pain
from lumbosacral dorsopathy significantly contributes to long-term disability. This review analyzes current
diagnostic and therapeutic practices through a systematic examination of scientific literature, highlighting the
potential benefits and limitations of combining Western and traditional Korean medical approaches.
Keywords:
Non-specific pain; lumbosacral dorsopathy; traditional Korean medicine; quality of life.
Introduction:
Currently, back pain is termed
"dorsopathy" and is included in the nosological group
of diseases of the osteomuscular system and
connective tissue. The leading symptom-complex of
dorsopathy is a non-visceral pain in the trunk and
extremities. The structure of the dorsopathy
classification includes deforming dorsopathy (in spinal
deformities, degeneration of intervertebral disks
without
their
protrusion,
spondylolysthesia);
dorsopathy due to protrusions of degenerative disks
with pain syndrome; dorsalgia and sympathatia [1].
According to the World Health Organization,
complaints of back pain are the second most common
cause of visiting a GP. Back pain troubles people of
various professions living in different continents with
the similar frequency [4]. At present, about 780 million
adults have LSD symptoms, and the probability of LSD
among people at risk is about 40%. It should be noted
that the LSD has a significant impact on work and
household components of people’s life as in about 70%
of cases LSD is the cause of disability and significant
restrictions in household activity [5]. Although episodes
of back pain associated with LSD are often short, about
25% of patients subsequently develop a clinical picture
of chronic pain, which is the main cause of long-term
disability. Also such LSD symptoms as lower back pain,
loss of leg muscle function, impairment of various types
of sensitivity in lower extremities and others can
portend a significant decrease in the patients’ quality
of life [6].
Milestones in the diagnosis of LSD-associated pain
syndrome: The contemporary clinical guidelines on
diagnosis of pain syndrome in LSD are based on the
diagnostic stratification, when patients with lower back
pain are assigned into one of four broad categories:
patients with visceral disease (e.g. nephrolithiasis),
specific spinal diseases (such as axial spondylitis),
radicular syndrome or non-specific lower back pain [7].
A. Downie et al. (2013) analyzed the frequency of
identification of categories of pain syndrome causes
and revealed that in primary health care settings, most
patients were found to complain of non-specific lower
back pain (about 90% of patients) [8]. When the pain
has persisted for more than 3 months, many patients
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meet the ICD-11 criteria of chronic primary pain.
Usually <1% of patients with back pain who seek
primary medical care have diseases of internal organs
or the spine [9].
The stratification of pain syndrome in LSD is an
essential element as it is directly associated with
treatment of patients. Diagnostic examination of
patients with LSD is used to identify people with
suspected specific spinal or internal diseases, who need
deeper diagnostic search and referral to specialists of
other medical specialties. In most cases, both non-
specific lower back pain and radicular syndrome do not
require additional diagnostic measures other than MRI
and routine clinical examination to identify the risk of
pathology requiring surgery. Warning signs, or so-
called “red flags”, such as unexplained
rapid weight
loss, traditionally is used to identify patients with a
higher probability of bladder or colon dysfunction, hard
drug users, recent infection, oncological diseases [8].
The meta-analysis of scientific data made by N.
Henschke et al. (2009) obtained the data on the most
common problems of screening patients with LSD
associated with these “red flags” that gives nearly 80%
of false positive results. Patients who seek primary care
have at least one warning symptom given that < 1.0%
of patients have a specific spinal abnormality in LSD
[10]. In addition to application of the “red flags”
diagnostic criterion, recently other criteria, i.e.
“orange, yellow, blue” and “black” flags for LSD
patients have become popular, where
“orange” means
mental stat
us disorder, “yellow flag” indicates
cognitive, emotional and behavioral status impairment,
”blue” one means labor ability disorder and “black”
implies systemic impairment [11].
R.Chou et al. (2011) believe that in order to identify
patients who need deeper diagnostic examination,
some guidelines take into account the consequences of
missed diagnosis and certainty of diagnosis. For
example, the American College of Physicians' Imaging
Manual
recommends
postponing
diagnostic
procedures until completion of a trial therapy for
patients with low suspicion for cancer. However, it
offers immediate further diagnostic examination of
patients with suspected “horse tail” syndrome (in
which compression of the nerve roots of the “horse
tail” causes loss of motor and se
nsory function) and
infection (e.g., epidural abscess) due to adverse
consequences of late diagnosis [12]. Many patients
with non-specific pain (NSP) recover after treatment;
however, about 15% of patients may have chronic pain,
up to disability development [13]. This largely causes
and explains a high level of expenses and suffering of
patients with chronic pain associated with LSD.
Prevention of NSP is therefore important, and early
detection of such patients is an urgent problem that the
world scientific community is trying to solve [14]. The
existing tools for early screening of LSD-associated NSP
among
patients
include
the
“STarTBack”
musculoskeletal pain screening questionnaire [15]. In
addition to the complex characterization of LSD-pain
associated,
STarTBack’s stratification tool assesses
psychological and social factors including the risk of
emotional distress, signs of fear avoidance, self-
evaluation of functioning and expected return to
working capacity [16]. Predictive assessment of the risk
of disability and reduced motor activity of patients with
LSD-associated pain was made in a number of clinical
trials with “STarTBack” which became a routine
practice of many clinical specialists around the world
[17]. The short version of the “STarTBack”
questionnaire takes a short time to complete, and can
reliably assign people into groups with low, medium
and high risk of potential disability associated with
lower back pain. Despite the widespread use of this
questionnaire, it is not still a perfect tool for screening
patients with LSD-associated pain but it is a useful
assistant to the clinical specialist [18].
Current therapy for pain in lumbosacral dorsopathy:
recent research and many international experts do not
always agree on a common approach to the
conservative treatment of pain in LSD. The controversy
in the therapeutic data of the existing protocols, in our
opinion, is related to the complexity of the
pathogenesis of this pathology, such as the pathology
of the intervertebral discs, the articular-ligament
apparatus of the spine, etc. In addition, there is no
universal medicine that could fully meet all
requirements of efficiency and safety in the treatment
of pain syndrome associated with LSD [19]. Currently,
conservative treatment of pain associated with LSD
uses a variety of approaches, most of which imply
multidisciplinary and multi-component therapy, which
confirms and stresses the complexity of the
mechanisms of pathogenesis of pain syndrome in LSD
[20]. A number of first-line drugs can be used in any
period for LSD patients with NSP syndrome [21]. Non-
steroid anti-inflammatory drugs (NSAIDs) can be
included in the first line of drugs, but their side effects
need to be considered and individual selection of cyclo-
oxygenase selective inhibitors (COX) COX-1 or COX-2
[22] should be carried out. An important feature in
prescribing treatment for NSP is the duration of the
NSAID course, which is limited to 15 days regardless of
the
pathology
[23]. As alternative
first-line
medications, narcotic analgesics are often used, which
effectively relieve pain syndrome. It is worth noting
that despite the pronounced analgesic effect of
narcotic analgesics, there is a problem of their
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prescription. Frequent mistakes of specialists related to
calculation of dosage and treatment of narcotic
analgesics can contribute to development of drug
abuse in patients [24].
Other first-line drugs for treating NSP in LSD patients
are corticosteroids. According to M.T.Vogt et al. (2005),
corticosteroids reduce the activity of systemic and local
inflammatory processes and local destructive
biochemical processes in the div [25]. This group of
drugs has proven to be an effective anti-inflammatory
medicine, subject to reservations of the side effects
that arise (Itsenko-Cushing syndrome, hyperglycemia,
risk of diabetes mellitus, various infectious processes,
disruption of collagen synthesis, and aggravation of
gastric and postbulbar ulcer disease [26]. Therefore,
hormonal drugs are recommended in a short course in
strict dosages or injectable forms of corticosteroids
[22].
Second line drugs are considered to be at least as
effective as the first line ones for treatment of NSP in
LSD patients [27]. These include anticonvulsants whose
effect is based on the similarity of their chemical
structure to gamma-amino-sulfuric acid (GABA). The
active substance molecule binds to α2
-
δ subunit of
potential-dependent calcium channels of nociceptic
neuron membrane and their activity decreases [28].
Common adverse effects of anticonvulsants are
dizziness, drowsiness, general weakness, which greatly
hampers any physical activity of the patient [29].
Muscle relaxants are other second-line drugs that allow
relaxing the hypertonic muscles of the posterior part of
the trunk, which significantly improves the prediction
of recovery of patients with NSP in LSD. Taking muscle
relaxants is closely associated with the risk of
developing muscle weakness, myalgia, asthenia, sleep
and wakefulness disorders [30].
Current application of non-medicament therapeutic
methods to LSD patients: non-medicament therapy of
NSP in LSD patients is based on the approach to
stratification of disability risks associated with chronic
pain [31]. As a rule, patients are seeking for medical
due to an episode of acute back pain; and in primary
care settings, physicians have the opportunity to
stratify the patients’ condition according to the level of
disability risk and choose the subsequent therapeutic
intervention tactics [32]. As mentioned earlier, it is
preferable to treat low-risk patients with simple
conservative methods, such as self-training and pain
control programs, resumption of daily activities or re-
activation (physical function recovery programs) [33].
People at a higher risk receive more complex therapies
to eliminate the risk factors and prevent further
development of pain and related disability [34, 35]. The
global awareness of the current recommendations for
the treatment of lower back pain is becoming
increasingly clear when examining the therapeutic
approaches of the past [36]. Until the early 1990s,
treatment for episodes of acute lower back pain often
involved such interventions as epidural steroid
injections, opioid administration, surgery or strict bed
rest [37, 38]. However, these interventions were not
more effective than natural recovery, and were often
expensive and accompanied by serious complications
[39]. Due to the excessive number of complications
that occurred in the context of the treatment of non-
specific lumbar pain, the world medical community
decided to switch to early therapeutic intervention
programs, often consisting of physical therapy and
exercise techniques. However, this approach did not
prevent the development of chronic pain [40, 41]. The
modern concept of treating NSP was suggested to be
formed by understanding that the psycho-emotional
factor is fundamental to the development of NSP and
the outcome of its treatment. This thesis is supported
by P. Jellema who assessed the level of psycho-
emotional disorders and the impact of therapeutic
factors on the population of patients seeking medical
treatment for NSP [42]. Having analyzed the obtained
findings P.Jellema, D. Van der Windt et al. (2008), and
M.K.Nicholas identified two ways of therapeutic
intervention for patients with NSP: targeted
therapeutic interventions based on pain-related
disability risk factors and ensuring adequate
interventions, specifically addressing the relevant
issues, including psychological and social risk factors
[42, 11, 43]. In the study conducted by A.C.Traeger, the
clinical data of patients with LSD-associated pain were
analyzed, and there were no signs of specific pathology
and structural disorders of the lumbar-sacral spine.
Statistically significant differences (p<0.05) were
obtained between qualitative and quantitative results
of treatment for NSP among patients who received the
standard therapy and those who were recommended
non-medicament therapy with an accelerated program
of return to normal daily activities. The patients, having
medium to low risk of potential disability and receiving
an accelerated program of non-medicament physical
recovery, noted higher rates of physical and psycho-
emotional components of health faster than patients
receiving the standard medication. However, the
authors stressed the importance of systematic
monitoring of patients with medium and high risk of
disability to ensure a rapid response to a NSP relapse or
lack of clinical improvement [44].
S.J.Linton et al. (2018) emphasized the importance of
special attention and monitoring the therapy provided
to patients at a high risk of disability due to NSP.
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Although patients in this risk group may initially seek
medical attention for acute pain syndrome, which may
reflect an exacerbation of chronic conditions, the
kinetic specialist should not delay the possibility of
applying combined therapeutic methods, as this
significantly reduces the risk of disability. If the
objectives of therapeutic interventions in high-risk
patients remain unclear, the additional psychosocial
assessment should be applied before continuing the
individual selection of therapies. Psycho-emotional and
psycho-social assessment facilitates the most justified
therapeutic impact in patients at high risk of disability
[45]. Often the treatment of patients with high risk of
disability can be a long and complex process; the results
of modern therapeutic approach give very encouraging
results, but require further clinical study [46, 47].
When treating LSD patients with a high risk of disability
and NSP, one of approaches is to offer a psychologically
based prevention program as a supplement to medical
care. The basis of this technique is to convince the
patient that his/her condition is not dangerous and the
patient can participate in physical activity during the
therapy [44]. High-risk patients are offered a
preventive program of cognitive and behavioral
therapy aimed at removing barriers to physical activity.
This program usually includes methods of “expanding”
the physical capabilities of the patient, e.g. re-
activation (that means restoring physical function),
learning how to reduce anxiety, pain and stress through
self-control and solving problems as they occur [14,
11].
Some studies demonstrated a decrease in working
ability and treatment demand for a period of 1 to 5
years in high-risk patients stratified by the advanced
STarTBack questionnaire, which has proved its
effectiveness in LSD patients with NSP [48]. It is worth
noting that such methods of cognitive-behavioral
therapy and the use of STarTBack-type questionnaires
can be applied by both neurologists and specialists in
the field of medical rehabilitation and physiotherapy
[32, 49]. This increases the availability of
psychologically based therapeutic interventions for
patients with NSP.
The direct forms of non-medicament therapy for NSP
include physical exercise and physiotherapy prior to
the beginning of pharmacological treatment, and after
a course of medication for pain associated with LSD
[50]. Supervised exercise programs are effective to
prevent lower back pain and to treat chronic but not
acute lower back pain [51]. The type of the exercise
program does not seem to matter as many kinds of
exercises are useful, including yoga, tai chi, motor
control exercises, step-by-step activity and pilates,
although many of these exercises are not suitable for
direct treatment. Most of the recommendations are
limited to local physical exercises for the spine, but
there is evidence of physical rehabilitation with
exercises for the whole div, including strength
exercises, isometric exercises, and aerobic exercises
with cardiovascular parameters. Application of
exercises in NSP therapy is usually contraindicated only
to patients with lower back pain caused by serious
pathology, such as fracture or infection; however,
caution or adaptation of the exercise program may be
required if patients have such co-morbidities as
respiratory or cardiovascular diseases [52].
The recommendations for treatment of chronic lower
back pain are consistent. For all patients with pain,
initial care should include explaining the causes and
self-management of pain, reassuring and encouraging
the patients to remain physically active and
recommending self-help options (such as analgesia and
muscle relaxation). Patients who do not respond to this
approach, or patients who need more complex or
intensive therapy (based on risk assessment), can
obtain additional treatment such as structured
exercises, traditional medicine, reflex therapy,
physiotherapy, spinal manipulation or cognitive
behavioral therapy.
Modern concepts of physical rehabilitation of LSD
patients: medical rehabilitation programs, applied to
LSD patients with NSP are multidisciplinary
interventions and involve several medical professionals
[53]. These rehabilitation programs are generally based
on a biopsychosocial approach and include: a
combination of self-learning, physical, cognitive,
behavioral, social and/or work-related components.
These rehabilitation programs are often carried out by
a team of medical professionals with experience in
various
fields
(neurology/reflexology/manual
therapy/physical medicine) [54]. Most programs
provide a phased approach to physical activity that
recommends patients gradually increase their daily
activity in accordance with individual life goals and also
gradually reduce the amount of rest and medication
[55]. In Cochrane’s systematic review conducted by
S.J.Kamper , the effectiveness of multidisciplinary
rehabilitation programs for patients with non-specific
lumbar pain was evaluated. The results showed that
multidisciplinary programs were significantly more
effective than the standard rehabilitation in which only
one medical professional participated [56]. Such
programs of multidisciplinary rehabilitation of LSD
patients with NSP include protocol “RENaBack”
developed and tested by L.Puerto Valencia et al.
(2021). This protocol includes both multidisciplinary
rehabilitation for patients with NSP and post-operative
rehabilitation for patients with specific lumbar-sacral
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pain after surgical treatment. The main advantage of
this multidisciplinary rehabilitation program is the
patient’s compliance, as well as the possibility of
applying protocol “RENaBack” to patients living far
from major medical centers [56].
Program “RÜCKGEWINN”, developed by a team of
specialists led by C.Hentschke for patients with chronic
non-specific lumbar pain, offers multidisciplinary
rehabilitation for both out-patient and neurological
patients. This program is considered effective, but the
multicenter study showed some logistical and
methodological problems when using RÜCKGEWINN
protocol [57]. R.M. Van Erp presented the primary
health
care
program
as
a
multidisciplinary
rehabilitation program “Back on Track” for patients
with NSP associated with LSD. This protocol implies a
biopsychosocial model of integrated therapeutic
intervention in primary health care facilities. The
efficiency of application of “Back on Track” protocol,
analyzed in the multicenter study, demonstrated high
financial efficiency owing to early detection of patients
with high risk of disability and timely provision of
appropriate therapeutic care through active use of
physical therapy devices [58].
There is a large number of published data on the impact
of various protocols of multidisciplinary rehabilitation
of LSD patients suffering from NSP and the
effectiveness of their application [59, 60, 61]. Recently,
however, there has appeared a growing div of
evidence comparing the evaluation of the effectiveness
or joint application of so-
called “Western” therapeutic
techniques and traditional medicine methods
(Chinese/Korean/Indian). One of such study is the work
of H.Y.Lee et al. (2021) who analyze the comparative
effectiveness of traditional Korean and “Western”
medicine among patients with various types of
neurological pain, including non-specific lumbar pain.
In a multi-center prospective study, the researchers
included 150 patients with non-specific lumbar pain
from 7 South Korean medical institutions. The
participants of the study had individual plans of
therapeutic interventions; one group of patients was
treated by the traditional methods of Korean medicine
(TKM), (acupuncture and manual therapy), the second
group, was treated according to the protocol of
multidisciplinary “Western” medicine and the third
group of patients received the combined therapy
including TKM and “Western” methods. The
effectiveness was assessed through the analysis of the
ODI Disability Index and the Quality of Life
Questionnaire (QSL) EuroQol 5 (EQ-5D-5L). The
researchers noted that those patients with lumbar-
sacral NSP, who received TKM interventions, had better
results, compared to the patients with pain syndrome,
who were included in the program of “Western”
treatment methods [62]. In another study of the clinical
and economic efficiency of TKM in the form of manual
intervention method “CHUNA”, B.C.Shin and K.T.Lim
revealed significant effectiveness of TKM “Chuna”
among patients with chronic non-specific lumbar-sacral
pain, especially in combination with drug therapy [63,
64]. The use of acupuncture in cases of chronic NSP in
LSD does not play a significant therapeutic role, which
is supported by major scientific studies over the past 20
years. Despite this, acupuncture undoubtedly has wide
application among patients with acute neurological
pain as well as myofascial pain syndrome [65, 66, 67,
68]. The centuries-long history of East Asian traditional
medicine certainly has great relevance and potential
effectiveness in addressing the problem of complex
therapeutic effects in patients with chronic pain
associated with LSD [62]. Hence, one of the most
promising traditional therapeutic interventions for
patients with non-specific pain in the lumbar-sacral
area is TKM. The mechanism of action of TCM is based
on manual and acupuncture therapy, which allows
applying a directed stimulating effect on the peripheral
nervous system. In turn, it reduces pain syndrome
trough excitation of tactile proprioceptive sensitivity
improving the impulse passing in the motor and sensor
system [69].
The opposite, in the scientific sense, method of both
rehabilitation of patients and therapy is physical
therapy (e.g. the ultrasonic effect on the damaged area
by high-frequency sound waves; magnetotherapy;
amplipulserapy; diadynamic currents; laser therapy;
darsonvalization; detector therapy; shock-wave
therapy;
ultraviolet
radiation).
Application
of
physiotherapy to NSP in LSD patients is considered to
be a sufficiently studied and developed direction of
research.Various physiotherapy methods combined
with physical rehabilitation techniques are included in
many multidisciplinary rehabilitation programs for LSD
patients with NSP. Notable physiotherapy techniques
include magnetic stimulation of the paravertebral,
square and deep lumbar muscles, and transcranial
magnetic stimulation (TMS) for chronic and acute NSP
associated with LSD. It is important that, unlike other
physiotherapy methods, TMS is not only a method of
rehabilitation, but it has the potential of a separate
method of treatment of this category of patients. For
example, the study conducted by S.Shafiee
demonstrated the pronounced effect of TMS against
the background of safe stimulation of cortical neurons
and reduction of chronic pain conditions. In addition,
the authors stressed that repeated transcranial
stimulation can increase neuroplasticity, which
inevitably leads to long-term therapeutic effects [70].
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In the study carried out by M.Ambriz-Tututi , TMS
therapy for 7 procedures made once a day to LSD
patients with NSP leads to long-term pain relief without
any side effects [71]. E.J.Park was able to confirm the
clinical effectiveness of TMS in the treatment of chronic
pain in LSD patients. In addition, the author stressed
the pronounced clinical effect on chronic pain
associated with depression and insomnia [72]. Over
786 publications, including 61 placebo-controlled
studies (3682 people), in PubMed.gov describe
application of TMS in depression. The effect of TMS in
depression can be explained by the fact that excitation
by means of high-frequency TMS of the prefrontal
cortex can activate the regulatory pathways that link
this region to the limbic system responsible for
emotional response and mood regulation [73]. It
should be noted that rather satisfactory effect of TMS
application is directly related to the pathogenetic
mechanism,
i.e.
disturbed
excitability
and/or
reorganization of the motor cortex of the brain, leading
to proprioceptive pain [74]. It is believed that the use
of modalities that precisely guide changes in the motor
cortex under XBP can not only reverse these changes
and improve clinical outcomes, but also reduce to some
extent the degree of disability, as well as influence the
quality of life in patients with NSP syndrome of the
lumbar region [75].
СONCLUSION
Considering the above, pain syndrome associated with
lumbosacral dorsopathy (LSD) continues to pose a
major global healthcare challenge, highlighting the
ongoing need for refined therapeutic strategies. While
effective management of this syndrome can
significantly reduce the risk of disability, the path to
achieving optimal outcomes remains complex. Current
research reflects the use of diverse therapeutic and
rehabilitation approaches in treating patients with
chronic pain. However, only limited studies have
explored the potential benefits of integrating
pharmacological treatment with traditional medicine
and physiotherapy techniques such as transcranial
magnetic stimulation (TMS) in LSD-related pain
management. Although each modality has shown
promise individually, their combined effect, especially
in terms of enhancing patients’ quality of life, remains
under-investigated. Further exploration into how these
methods interact and contribute to recovery may offer
new insights into comprehensive treatment models.
Understanding the factors that influence the quality of
life in individuals with chronic lower back pain is
therefore crucial in shaping future interventions. In
light of this, the present study aims to evaluate how a
multidisciplinary treatment approach affects quality of
life in patients with chronic pain caused by LSD.
REFERENCES
Kotova OV. Treatment of back pain [Лечение боли в
cпине]. RMZh. 2012;20(8):414
-6. Russian.
Levin О.S. Spinal sacral radiculopathy: modern
approaches
to
diagnosis
and
treatment
[Вертеброгенная
пояснично
-
крестцовая
радикулопатия:современные
подходы
к
диагностике
и
лечению]
//
Effective
pharmacotherapy. 2015;23:40
–
49. Russian
Solovieva E., Jutova E. Neurological complexes of group
B vitamins as an important component of the complex
treatment of radiculopathy
. [Нейропные комплексы
витаминов группы В как важная составляющая
комплексного лечения радикулопатии]. Doctor.
2012; (9):41-5. Russian
Odinak M.M., Zhovolupov S.A. Diseases and injuries of
the peripheral nervous system.[ Заболевания и
травмы периферической нервной системы.] Saint
Petersburg: SpecLit, 2009. 384 p. Russian
Titova N.V. Patient with non-specific lower back pain:
algorithm of diagnosis and therapy [Пациент с
неспецифической болью в нижней части спины:
алгоритм диагностики и терапии] // Rus
sian medical
journal. Medical review. 2016;24(12):775
–
781. Russian
Koes B.W. et al. An updated overview of clinical
guidelines for the management of non- specific low
back pain in primary care. Eur. Spine J. 19, 2075
–
2094
(2010).
Downie A. et al. Red flags to screen for malignancy and
fracture in patients with low back pain: systematic
review. BMJ 347, f7095 (2013).
Nicholas M. et al. The IASP classification of chronic pain
for ICD-11: chronic primary pain. Pain 160 28
–
37
(2019).
Henschke N. et al. Prevalence of and screening for
serious spinal pathology in patients presenting to
primary care settings with acute low back pain. Arthritis
Rheum. 60, 3072
–
3080 (2009).
Nicholas M.K., Linton S.J., Watson P.J. & Main C.J. Early
identification and management of psychological risk
factors (“yellow flags”) in patients with low back pain:
a reappraisal. Phys. Ther. 91, 737
–
753 (2011).
Chou, R., Qaseem, A., Owens, D. K. & Shekelle, P.
Diagnostic imaging for low back pain: advice for high-
value health care from the American College of
Physicians. Ann. Intern. Med. 154, 181
–
189 (2011).
Maher C., Underwood M., Buchbinder R. Non-specific
low back pain. Lancet 389, 736
–
747 (2017).
Linton S., Flink I., Vlaeyen J. Understanding the etiology
of chronic pain from a psychological perspective. Phys.
Ther. 98, 315
–
324 (2018).
International Journal of Medical Sciences And Clinical Research
85
https://theusajournals.com/index.php/ijmscr
International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
Hill, J. C. et al. A primary care back pain screening tool:
Identifying patient subgroups for initial treatment.
Arthritis Rheum. 59, 632
–
641 (2008).
Gatchel R.J., Peng Y.B., Peters M.L., Fuchs P.N., Turk
D.C. The biopsychosocial approach to chronicpain:
scientific advances and future directions. Psychol. Bull.
133, 581
–
624 (2007).
Karran, E.L. et al. Can screening instruments accurately
determine poor outcome risk in adults with recent
onset low back pain? A systematic review and meta-
analysis. BMC Med. 15, 13 (2017)
Nicholas M.K. et al. Predicting return to work in a
heterogeneous sample of recently injured workers
using the brief OMPSQ- SF. J.Occup. Rehabil, (2018).
Lin J.H., Chiang Y.H., Chen C.C. Lumbar radiculopathy
and its neurobiological basis // World J Anesthesiol.
2014. Vol. 3. No. 2. P. 162
–
173.
White A.P., Arnold P.M., Norvell D.C., Ecker E., Fehlings
M.G. Pharmacologic management of chronic low back
pain: Synthesis of the evidence. Spine 2011; 36:S131-
S143
Chou R. Pharmacological management of low back
pain. Drugs 2010; 70:387-402
Hoy D., Bain C., Williams G., March L., Brooks P., Blyth
F., Woolf A., Vos T., Buchbinder R. A systematic review
of the global prevalence of low back pain. Arthritis
Rheum 2012; 24:181-191
Rozenberg S., Foltz V., Fautrel B. Treatment strategy for
chronic low back pain. Joint Bone Spine 2012; 79:555-
559
Bernstein I.A., Malik Q., Carville S.,Ward S. Low back
pain and sciatica: summary of NICE guidance. BMJ 356,
i6748 (2017).
Vogt M.T., Kwoh C.K., Cope D.K., Osiai T.A., Culyba M.,
Starz T.W. Analgesic usage for low back pain: Impact on
health care costs and service use. Spine 2005; 30:1075-
1081.
Licciardone J.C. The epidemiology and medical
management of lowback pain during ambulatory
medical visits in the United States. Osteopath Med
Primary Care 2008; 2:11.
Ivanova M.A., Parfenov V.A., Isaikin A.I. Conservative
treatment for patients with discogenic lumbosacral
radiculopathy: results of a prospective follow-up.
Neurology,
Neuropsychiatry,
Psychosomatics.
2018;10(3):59
–
65. (In Russ.).
Kennedy D.J., Zheng P.Z., Smuck M., et al. A minimum
of 5-year follow-up after lumbar transformational
epidural steroid injections in patients with lumbar
radicular pain due to intervertebral disc herniation.
Spine J. 2018;18(1):29
–
35.
Goldberg H., Firtch W., Tyburski M., et al. Oral steroids
for acute radiculopathy due to a herniated lumbar disk:
a randomized clinical trial. JAMA. 2015;313(19):1915
–
1923.
Cohen S.P., Hanling S., Bicket M.C., et al. Epidural
steroid injections compared with gabapentin for
lumbosacral radicular pain: multicenter randomized
double blind comparative efficacy study. Br Med J.
2015;350:h1748.
Linton S., Flink I., Vlaeyen J. Understanding the etiology
of chronic pain from a psychological perspective. Phys.
Ther. 98, 315
–
324 (2018).
Main C.J., George S. Z. Psychologically informed
practice for management of low back pain: future
directions in practice and research. Phys. Ther. 91, 820
–
824 (2011).
Linton S.J., Nicholas M., Shaw W. Why wait to address
high- risk cases of acute low back pain? A comparison
of stepped, stratified, and matched care. Pain 159,
2437
–
2441 (2018).
Linton, S. J. New Avenues for the Prevention of Chronic
Musculoskeletal Pain Vol. 1 306 (Elsevier Science,
Amsterdam, 2002).
Nicholas, M. K. & George, S. Z. Psychologically informed
interventions for low back pain: an update for physical
therapists. Phys. Ther. 91, 765
–
776 (2011).
Malmivaara A. et al. The treatment of acute low back
pain
—
bed rest, exercises, or ordinary activity? N. Engl.
J. Med. 332, 351
–
355 (1995).
Waddell G. The Back Pain Revolution 2nd edn
(Churchill- Livingstone, 2004).
Waddell G., Aylward M., Sawney P. Back Pain,
Incapacitiy for Work and Social Security Benefits: an
International Literature Review and Analysis (The
Royal Society of Medicine Press, 2002).
Deyo R.A., Mirza S.K., Turner J.A., Martin B.I.
Overtreating chronic back pain: time to back off? J. Am.
Board Family Med. 22, 62
–
68 (2009).
Sinclair S.J., Hogg-Johnson S. In New Avenues for the
Prevention of Chronic Musculoskeletal Pain and
Disability (ed. Linton, S. J.) 259
–
268 (Elsevier, 2002).
UK BEAM Trial Team. United Kingdom back pain
exercise and manipulation (UK BEAM) randomized trial:
effectiveness of physical treatments for back pain in
primary care. BMJ 329, 1377 (2004).
Jellema P. et al. Should treatment of (sub) acute low
back pain be aimed at psychosocial prognostic factors?
Cluster randomised clinical trial in general practice.
BMJ 331, 84 (2005).
Van der Windt D., Hay E., Jellema P., Main C.
International Journal of Medical Sciences And Clinical Research
86
https://theusajournals.com/index.php/ijmscr
International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
Psychosocial interventions for low back pain in primary
care: lessons learned from recent trials. Spine 33, 81
(2008).
Traeger A.C. et al. Effect of Primary Care- Based
Education on Reassurance in Patients With Acute Low
Back Pain: Systematic Review and Meta-analysis.
JAMA. Intern. Med. 175, 733
–
743 (2015).
Linton S.J. in Psychological Approaches to Pain
Management: a Practitioner’s Handbook (eds Turk
D.C., Gatchel R.J.) (Guildord Press, 2018).
Nicholas M. Preventing disabling chronic pain by
engaging psychologists in the acute phase. APS
https://www.psychology.org.au/inpsych/2016/august
/ nicholas/ (2016).
Foster N.E. et al. Effect of stratified care for low back
pain in family practice (IMPaCT Back): a prospective
population- based sequential comparison. Ann. Fam.
Med. 12, 102
–
111 (2014).
Schmidt P.A., Naidoo V. Cross-cultural adaptation and
validation of the STarT back screening tool in isiZulu. S
Afr J Physiother. 2020 Jun 1;76(1):1402.
O’Sullivan P. B. et al. Cognitive functional therapy: an
integrated behavioral approach for the targeted
management of disabling low back pain. Phys. Ther. 98,
408
–
423 (2018).
Williams C.M. et al. Efficacy of paracetamol for acute
low-back pain: a double- blind, randomized controlled
trial. Lancet 384, 1586
–
1596 (2014).
Steffens, D. et al. Prevention of low back pain: a
systematic review and meta- analysis. JAMA Intern.
Med. 176, 199
–
208 (2016).
Hoffmann T.C. et al. Prescribing exercise interventions
for patients with chronic conditions. CMAJ 188, 510
–
518 (2016).
Ahlfeldt DA, Vixner L, Stålnacke BM, Boersma K,
Löfgren M, Fischer MR, Enthoven P. Healthcare
Professionals' Perceptions of and Attitudes towards a
Standardized Content Description of Interdisciplinary
Rehabilitation Programs for Patients with Chronic Pain-
A Qualitative Study. Int J Environ Res Public Health.
2023 Apr 27;20(9):5661.
Reneman MF, Ansuategui Echeita J, van Kammen K,
Schiphorst Preuper HR, Dekker R, Lamoth CJC. Do
rehabilitation patients with chronic low back pain meet
World Health Organisation's recommended physical
activity levels? Musculoskelet Sci Pract. 2022
Dec;62:102618.
Puerto Valencia L, Arampatzis D, Beck H, Dreinhöfer K,
Drießlein D, Mau W, Zimmer JM, Schäfer M, Steinfeldt
F, Wippert PM. RENaBack: low back pain patients in
rehabilitation-study protocol for a multicenter,
randomized controlled trial. Trials. 2021 Dec
18;22(1):932.
Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJ,
Ostelo
RW,
Guzman
J,
van
Tulder
MW.
Multidisciplinary biopsychosocial rehabilitation for
chronic low back pain: Cochrane systematic review and
meta-analysis. BMJ. 2015 Feb 18;350:h444.
Hentschke C, Hofmann J, Pfeifer K. A bio-psycho-social
exercise program (RÜCKGEWINN) for chronic low back
pain in rehabilitation aftercare--study protocol for a
randomised controlled trial. BMC Musculoskelet
Disord. 2010 Nov 17;11:266.
van Erp RM, Huijnen IP, Verbunt JA, Smeets RJ. A
biopsychosocial primary care intervention (Back on
Track) versus primary care as usual in a subgroup of
people with chronic low back pain: protocol for a
randomised, controlled trial. J Physiother. 2015
Jul;61(3):155.
Hurley DA, Murphy LC, Hayes D, Hall AM, Toomey E,
McDonough SM, Lonsdale C, Walsh NE, Guerin S,
Matthews J. Using intervention mapping to develop a
theory-driven, group-based complex intervention to
support self-management of osteoarthritis and low
back pain (SOLAS). Implement Sci. 2016 Apr 26;11:56.
Holzapfel S, Riecke J, Rief W, Schneider J, Glombiewski
JA. Development and Validation of the Behavioral
Avoidance Test-Back Pain (BAT-Back) for Patients With
Chronic Low Back Pain. Clin J Pain. 2016
Nov;32(11):940-947.
Belache FTC, Souza CP, Fernandez J, Castro J, Ferreira
PDS, Rosa ERS, Araújo NCG, Reis FJJ, Almeida RS,
Nogueira LAC, Correia LCL, Meziat-Filho N. Trial
Protocol: Cognitive functional therapy compared with
combined manual therapy and motor control exercise
for people with non-specific chronic low back pain:
protocol for a randomised, controlled trial. J
Physiother. 2018 Jul;64(3):192.
Lee HY, Cho MK, Kim N, Lee SY, Gong NG, Hyun EH.
Comparative Effectiveness of Collaborative Treatment
with Korean and Western Medicine for Low Back Pain:
A Prospective Cohort Study. Evid Based Complement
Alternat Med. 2021 Jul 28;2021:5535857.
Shin BC, Kim MR, Cho JH, Jung JY, Kim KW, Lee JH, Nam
K, Lee MH, Hwang EH, Heo KH, Kim N, Ha IH.
Comparative effectiveness and cost-effectiveness of
Chuna manual therapy versus conventional usual care
for nonacute low back pain: study protocol for a pilot
multicenter, pragmatic randomized controlled trial
(pCRN study). Trials. 2017 Jan 17;18(1):26.
Lim KT, Hwang EH, Cho JH, Jung JY, Kim KW, Ha IH, Kim
MR, Nam K, Lee A MH, Lee JH, Kim N, Shin BC.
Comparative effectiveness of Chuna manual therapy
International Journal of Medical Sciences And Clinical Research
87
https://theusajournals.com/index.php/ijmscr
International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
versus conventional usual care for non-acute low back
pain: a pilot randomized controlled trial. Trials. 2019
Apr 15;20(1):216.
Mu J, Furlan AD, Lam WY, Hsu MY, Ning Z, Lao L.
Acupuncture for chronic nonspecific low back pain.
Cochrane
Database
Syst
Rev.
2020
Dec
11;12(12):CD013814.
Lu F, Ren P, Zhang Q, Shao X. Research Trends of
Acupuncture Therapy on Myofascial Pain Syndrome
from 2000 to 2022: A Bibliometric Analysis. J Pain Res.
2023 Mar 21;16:1025-1038.
Huang L, Xu G, He J, Tian H, Zhou Z, Huang F, Liu Y, Sun
M, Liang F. Bibliometric Analysis of Functional Magnetic
Resonance Imaging Studies on Acupuncture Analgesia
Over the Past 20 Years. J Pain Res. 2021 Dec
10;14:3773-3789.
Huang L, Xu G, Sun M, Yang C, Luo Q, Tian H, Zhou Z, Liu
Y, Huang F, Liang F, Wang Z. Recent trends in
acupuncture for chronic pain: A bibliometric analysis
and review of the literature. Complement Ther Med.
2023 Mar;72:102915.
Kim G, Kim D, Moon H, Yoon DE, Lee S, Ko SJ, Kim B,
Chae Y, Lee IS. Acupuncture and Acupoints for Low Back
Pain: Systematic Review and Meta-Analysis. Am J Chin
Med. 2023;51(2):223-247.
Shafiee S, Hasanzadeh Kiabi F, Shafizad M, Emami Zeydi
A. Repetitive transcranial magnetic stimulation: a
potential therapeutic modality for chronic low back
pain. Korean J Pain. 2017 Jan;30(1):71-72.
Ambriz-Tututi M, Alvarado-Reynoso B, Drucker-Colín R.
Analgesic effect of repetitive transcranial magnetic
stimulation (rTMS) in patients with chronic low back
pain. Bioelectromagnetics 2016; 37: 527-35.
Park EJ, Lee SJ, Koh DY, Han YM. Repetitive transcranial
magnetic stimulation to treat depression and insomnia
with chronic low back pain. Korean J Pain 2014; 27: 285-
9.
O’Reardon JP, Solvason HB, Janicak PG, Sampson S,
Isenberg KE, Nahas Z, McDonald WM, Avery D,
Fitzgerald PB, Loo C, Demitrack MA,George MS,
Sackeim HA. Efficacy and safety of transcranial
magnetic stimulation in the acute treatment of major
depression: a multisite randomized controlled trial. Biol
Psychiatry. 2007;1:62(11):1208-1216.
Parker RS, Lewis GN, Rice DA, McNair PJ. Is motor
cortical excitability altered in people with chronic pain?
A systematic review and meta-analysis. Brain Stimul
2016; 9: 488-500.
Pelletier R, Higgins J, Bourbonnais D. Is neuroplasticity
in the central nervous system the missing link to our
understanding of chronic musculoskeletal disorders?
BMC Musculoskelet Disord 2015; 16: 25.
