Acute neck pain: principles of diagnosis and treatment

In accordance with modern concepts, pain is divided into neuropathic and nonspecific (nociceptive). Often the pain syndrome is of a mixed nature, combining the features of both options, each of which requires a separate approach to treatment. The main task of pain therapy is its effective and rapid relief with the relative safety of the prescribed treatment. The message is devoted to the analysis of a clinical case of treatment of pain of a mixed nature, acutely developed in a patient in the cervical spine as a result of inadequate physical activity, which led to damage to the intervertebral disc and complicated cervical radiculopathy. Selftreatment performed by the patient, which included, among other things, NSAIDs, did not lead to the desired result due to the inadequacy and lack of systemic therapy. In order to establish a clinical diagnosis, both physical and paraclinical research methods were used, which made it possible to verify the cause of neck pain and the nature of the complications that developed. In order to quickly relieve the pain syndrome, a stepwise scheme of therapy with dexketoprophen was used, which led to the desired effect within 5 days (a decrease in pain intensity by more than 50% from the initial level). To continue treatment, NSAIDs with a selective effect on COX-2 were used. Also, according to the indications, the complex therapy included drugs of the following groups: proton pump inhibitor, muscle relaxant, anticonvulsant, combined preparation of B vitamins, thioctic acid preparation, combined preparation from the group of slow-acting symptomatic agents and non-drug methods (cognitive-behavioral therapy, soft tissue manual therapy techniques, Exercise therapy). The adequacy of the therapy was confirmed by relief of pain syndrome and regression of neurological symptoms in the absence of adverse events. This clinical case illustrates the possibilities of successful conservative treatment of mixed pain in an outpatient setting.