[Pain, emotion, cognition. Pathogenetic relationships and effects of therapy with nonsteroidal anti-inflammatory...

To study the dynamics of pain intensity in comparison with changes in the severity of depression and cognitive deficits when using non-steroidal anti-inflammatory drugs and/or central muscle relaxants in patients with chronic non-specific back pain.

Sixty patients (26 men and 34 women), aged 42 to 59 years, with chronic non-specific back pain were examined. All patients were divided into three groups. In the first group, dexketoprofen was used at a dose of 75-100 mg per day for 10 days. Patients of the second group received dexketoprofen according to a similar scheme, as well as tolperisone (200-450 mg per day) for 30 days. Patients of the third group took diclofenac sodium (100 mg per day) for 10 days. The intensity of pain, its affective component, the severity of asthenic, depressive, anxiety manifestations and cognitive disorders were tested at baseline and on the 10th and 30th days.

Pain significantly decreased in all patients, more significantly in the first and second groups. The analgesic effect in the first and third groups was unstable, and the improvements achieved by the last test were partially reduced. In patients of the first and second groups, regression of anxiety and depressive symptoms was observed from day 10 to the end of observation. At the same time, the emotional assessment of pain in patients of the first group decreased by the 10th and increased by the 30th day of observation. By the end of the study, patients of the second group showed positive dynamics of indicators of asthenia and cognitive disorders.

The most effective analgesic therapy using a combination of dexketoprofen and tolperisone was accompanied by a positive dynamics of depressive manifestations and cognitive disorders. The choice of an algorithm for treating pain should take into account the need and possibility of treatment its biological and psychological (affective, cognitive) components.