[Chronic pain syndrome in diseases of periarticular tissues]

The search for an effective method of treating diseases of the musculoskeletal system is a rather actual problem for a practicing physician nowadays in connection with the modern lifestyle of most people. A prolonged stay in the same position, as a rule, leads to overstrain of the capsule-joint complexes, and, as a consequence, to the development of degenerative changes in the joints and periarticular tissues. These changes can manifest themselves clinically in the form of a chronic or acute pain syndrome. One of the common diseases characterized by degenerative periarticular changes with a variety of clinical manifestations are periarthropathies. Periarthropathy or periarthrosis is still the subject of discussion by doctors of related specialties: neurologists, orthopedists, rheumatologists, etc. Pain in this case can be caused by the primary degenerative process in muscles and tendons in combination with their chronic microtraumatization, ischemia, and reactive inflammation. Periarthropathy can be considered as a «train» of any arthropathy, because pain always causes muscle spasm, a change in the motor stereotype, a limitation of motor activity in the joint, etc. In the absence of joint pathology, it should be considered as a primary disease. There is still no common understanding of this nosological unit, including pathogenesis, classification, diagnostic algorithms and therapy. Treatment is based on general recommendations: limiting the load on the damaged joint, massage (according to indications), exercise therapy, manual therapy, physiotherapy. Drug therapy includes intramuscular or intraarticular administration of glucocorticosteroids (GCS), non-steroidal anti-inflammatory drugs (NSAIDs) but these drugs have certain side-effects and contraindications. Treatment of peritropathy with chondroprotectors (chondrogard) is rapidly gaining momentum, as well as GCS and NSAIDs, they reduce pain and increase the functionality of the joints, but, unlike the latter, their safety profile is much higher. The authors summarize current findings on this issue.