FEATURES OF PAIN SYNDROSIS IN WOMEN WITH DISEASES OF THE PELVIC ORGANS IN NEUROLOGICAL PRACTICE
Keywords:
pain syndrom, inflammatory diseases, dorsopathies, pelvic diseasesAbstract
Due to the increase in life expectancy and the increase in the number of people who lead a sedentary lifestyle, it became necessary to take measures to combat diseases of the musculoskeletal system. At the moment, the most common diseases of the musculoskeletal system are degenerative and inflammatory diseases of the joints, as well as osteoporosis. [36]. However, in addition to diseases of the musculoskeletal system, a large role should be given to somatic pathology, accompanied by back pain. Pain syndromes in diseases of the pelvic organs in women is a complex problem that requires a multisystem approach in cooperation not only with gynecological specialists, but also with neurologists, urologists, surgeons and other specialists. Long-term pain syndrome leads not only to physical discomfort, but also to moral discomfort and leads to loss of ability to work, and problems in the family. The main localization of pain syndromes in diseases of the pelvic organs in women is the pelvic region and back. Chronic pelvic pain lasts more than six months, is not related to the menstrual period and can lead to disability, and may also require surgical or medical intervention.
According to the definition in ICD-10, dorsopathies are understood as a complex of lesions of the musculoskeletal system with the involvement of connective tissue elements, accompanied by pain syndrome in a certain area of the back and functional disorders [34].
The most life-threatening causes of back pain can be acute inflammatory diseases, complications of pregnancy, malignant neoplasms, both primary and secondary [28]. Treatment of pain syndromes has its own difficulties since there is often an incorrect diagnosis of the underlying cause and, as a result, it is difficult to select a pathogenetically substantiated therapy. The article presents the clinical features of the course of pain syndrome, diagnostic criteria, principles of management, diagnostic algorithm, as well as treatment tactics for patients with these problems.
References
Anaf V, Chapron C, El Nakadi I et al. Pain, mast cells, and nerves in peritoneal, ovarian, and deep infiltrating endometriosis. Fertil Steril 2006; 86 (5): 1336–43.
Anaf V, Simon P, El Nakadi I et al. Hyperalgesia, nerve infiltration and nerve growth factor expression in deep adenomyotic nodules, peritoneal and ovarian endometriosis. Hum Reprod 2002; 17 (7): 1895–900.
Aziz Q, Giamberardino MA, Barke A, et al. The IASP classification of chronic pain for ICD-11: chronic secondary visceral pain. Pain. 2019 Jan;160(1):69-76. doi: 10.1097/j.pain. 0000000000001362.
Benyamin R.M. et al. // Рain Physician. 2012. V. 15. № 4. P. E363.
Berkley KJ, Dmitrieva N, Curtis KS, Papka RE. Innervation of ectopic endometrium in a rat model of endometriosis. Proc Natl Acad Sci USA 2004; 101 (30): 11094–8. Epub 2004.
Berkley KJ, Rapkin AJ, Papka R.E. The pains of endometriosis. Science 2005; 308 (5728): 1587–9.
Carey TS, Garrett JM, Jackman A, Hadler N. Recurrence and care seeking after acute back pain: results of a long-term follow-up study. North Carolina Back Pain Project. Medical Care. 1999;37(2):157-164. https://doi.org/10.1097/00005650-199902000-00006
Cummins TR, Rush AM. Voltage-gated sodium channel blockers for the treatment of neuropathic pain. Expert Rev Neurother 2007; 7 (11): 1597–612.
Daniels J.P., Khan K.S. // BMJ. 2010. V. 341. P. c4834.
EAU guidelines on chronic pelvic pain 2012.
Engeler D, Baranowski AP, Borovicka J, et al. EAU guidelines on chronic pelvic pain. EAU Guidelines. EAU Annual Congress. Copenhagen; 2018. 84 p
Fall M, Baranowski AP, Fowler CJ et al. European Association of Urology. EAU guidelines on chronic pelvic pain. Eur Urol 2004; 46 (6): 681–9.
Gunter J. Chronic pelvic pain: an integrated approach to diagnosis and treatment. Obstet Gynecol Surv 2003; 58 (9): 615–23.
Hahn L. Chronic pelvic pain in women. A condition difficult to diagnose – more than 70 different diagnoses can be considered. Lakartidningen 2001; 98 (15): 1780–5.,
IASP. International Association for the study of pain «Pain terms» glossary. Pain 1986; 44–8 (Suppl. 3): 175–9.
Jarrell J.F. et al. // Obstet. Gynaecol. Can. 2005. V. 27. № 8. P. 781 17. Latthe P. et al. // BMJ. 2006. V. 332. № 7544. P. 749
Lippman S.A. et al. Uterine fibroids and gynecologic pain symptoms in a population-based study // Fertil Steril. 2003; 80: 1488. [PMID: 14667888].
Lipscomb GH, Ling FW. Chronic pelvic pain. Med Clin North Am 1995; 79 (6): 1411–25.
Lund I, Lundeberg T. Aspects of pain, its assessment and evaluation from an acupuncture perspective. Acupunct Med 2006; 24 (3): 109–
Manchikanti L. et al. // Рain Physician. 2012. V. 15. № 3. P. E199.
Million M, Wang L, Adelson DW et al. Pregabalin decreases visceral pain and prevents spinal neuronal activation in rats. Gut 2007; 56
(10): 1482–4.
Misra SC, Pandey RM. Efficacy of drotaverine in irritable bowel syndrome: a double-blind, randomized, placebo-controlled clinical trial. Am J Gastroenterol 2000; 95: 2544 (Abs 455)
Moalem G, Tracey DJ. Immune and inflammatory mechanisms in neuropathic pain. Brain Res Rev 2006; 51 (2): 240–64. Epub 2006.
Nicholas M, Vlaeyen JWS, Rief W et al. The IASP classification of chronic pain for ICD-11: chronic primary pain. Pain. 2019 Jan;160(1):28-37. doi: 10.1097/j.pain.0000000000001390.
Royal College of Obstetricians and Gynaecologists. The Initial Management of Chronic Pelvic Pain 2005; Guideline 41.
Scholz J, Woolf CJ. The neuropathic pain triad: neurons, immune cells and glia. Nat Neurosci 2007; 10 (11): 1361–8.
Vleeming A. et al. // Eur. Spine J. 2008. V. 17. № 6. P. 794. /// Ortiz D. // Am. Fam. Physician. 2008. V. 77. № 11. P. 1535.
Wesselmann U. Clinical characteristics and pathophysiology of pelvic pain in women. Schmerz 2002; 16 (6): 467–75.
Wolsko PM, Eisenberg DM, Davis RB, Kessler R, Phillips RS. Patterns and perceptions of care for treatment of back and neck pain: results of a national survey. Spine (Phila Pa 1976). 2003;28(3):292-298. https://doi.org/10.1097/01.BRS.0000042225.88095.7C
Zondervan K.T. et al. // Br. J. Obstet. Gynaecol. 1999. V. 106. P. 1149.
Адамян Л.В., Шаров М.Н., Сонова М.М. и др. Новый взгляд на хроническую тазовую боль в гинекологической практике. Эффективная фармакотерапия. Неврология и психиатрия. 2013; 3 (32): 24–9.
Батышева Т.Т., Шварц Г.Я. Диагностика и лечение болей в спине у женщин в постменопаузальном периоде. // Лечащий врач. – 2002. - № 12.
ВОЗ. Международная статистическая классификация болезней и проблем, связанных со здоровьем. Десятый пересмотр. Том 3. Алфавитный указатель. Всемирная организация здравоохранения, 1995. Пер. с англ. М.: Медицина; 2003.
Данилов А.Б. Нейропатическая боль. М.: Нейромедиа, 2003.
Насонов Е.Л. Международная декада, посвященная костно-суставным нарушениям (The Bone and Joint Decade 2000—2010). Русский медицинский журнал. 2000;8(9):369-371.
Ниаури Д.А., Попов Э.Н., Русина Е.И. и др. Опыт применения ангиопротекторов (Гинкор-Форт) в лечении больных с синдромом хронических тазовых болей. Регионарное кровообращение и микроциркуляция. 2003; 2 (6): 32–5.
Решетняк В.К., Кукушкин М.Л. Боль: физиологические и патофизиологические аспекты. В кн.: Б.Б.Мороз (ред.). Актуальные проблемы патофизиологии (избранные лекции). М.: Медицина, 2001.
Стеняева Н. Н., Аполихина И.А. Хроническая тазовая боль: психосоматические аспекты. Consilium Medicum. 2012; 6 (14): 19–
Стрижаков А. Н., Давыдов А. И. Эндометриоз. Клинические и теоретические аспекты. М.: Медицина, 1996.
Хирургическое лечение синдрома тазовых болей в гинекологической клинике / Под ред. Г.А.Cавицкого, Р.Д.Иванова,
И.Ю.Щеглова и др. СПб.: ЭЛБИ-СПб., 2003.
Хроническая тазовая боль. Руководство для врачей. Под ред. А.Н.Белова, В.Н.Крупина. М.: Антидор, 2007.