Medicina bolu <p>"Medicina bolu" is a science-and-practice periodical for medical professionals. The main highlighting issue is pain, but not the only one, because in medicine there are no situations where a phenomenon is strictly isolated. Sign up for a print edition and follow up on the site to keep up with important and useful information.</p> <p>Thematic interests of the journal<br>Fundamental aspects of pain (clinical physiology, pathophysiology, pharmacology).<br>Applied aspects of pain (epidemiology, pain assessment, innovative methods of diagnosis and treatment, clinical pharmacology).<br>Clinical aspects of pain (acute pain, chronic pain, perioperative pain, posthumous pain, neuropathic pain, dysfunctional pain).<br>Clinical and anatomical approach to pain (headache, orofacial pain, neck and back pain, toothache, musculoskeletal pain, myofascial pain, fibromyalgia, visceral pain, pelvic pain, cardialgia, etc.).<br>Interdisciplinary approach to pain (in anesthesiology, in surgery, in pediatrics, neurology, vertebrology, in the clinic of internal diseases, oncology, rheumatology, gerontology, gastroenterology, traumatology and orthopedics, otorhinolaryngology, dentistry, obstetrics, gynecology and urology, in the palliative and hospice medicine).<br>Treatment and rehabilitation of patients suffering from pain (pharmacotherapy, physical rehabilitation, medical rehabilitation, alternative methods of treatment, means of psychological and psychotherapeutic influence, invasive methods of pain relief, organization of pain relief).<br>Separate clinical cases and their clinical examination.</p> en-US <p><a style="background-color: transparent; color: #007ab2; font-family: &amp;quot; noto sans&amp;quot;,arial,helvetica,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: underline; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;" href="" rel="license"><img style="border-width: 0px;" alt="Creative Commons License" src=""></a><br style="background-color: transparent; color: #000000; cursor: text; font-family: &amp;quot; noto sans&amp;quot;,arial,helvetica,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; outline-color: #2d8ac7; outline-style: solid; outline-width: 2px; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;"><span style="display: inline !important; float: none; background-color: transparent; color: #000000; cursor: text; font-family: 'Noto Sans',Arial,Helvetica,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;">This work is licensed under a </span><a style="background-color: transparent; color: #007ab2; font-family: &amp;quot; noto sans&amp;quot;,arial,helvetica,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: underline; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;" href="" rel="license">Creative Commons Attribution 4.0 International License</a></p> (Oleksandr Marchuk) (Viktor Vitkovskyi) Wed, 07 Mar 2018 00:00:00 +0200 OJS 60 Theories of pain, up to Descartes and after neuromatrix: what role do they have to develop future paradigms? <p><span style="background-color: #ffffff;">The article represents a synthesis of literature about antique, medieval and modern pain theories. In short there are described the most relevant theories about nociception and pain. Chronologically there are presented the discoveries in physiology, anatomy, histology and other methods and investigations of pain. There is discussed the character of past pain theories and its influence on elaboration of the new ones. There was elaborated the hypothesis about the neuromatrix theory and impact of human microbiota on pain perception or other comorbidities with psychological and pain component. </span></p> I. Burmistr ##submission.copyrightStatement## Wed, 07 Mar 2018 00:00:00 +0200 Ultrasonic navigation – a single way for identification of brachial plexus nerves in patient with severe vascular pathology <p><span style="background-color: #ffffff;">The article discusses the successful experience of using ultrasound imaging of the brachial plexus nerves to perform a supraclavicular block of the brachial plexus with an additional block of n. cutaneus brachii medialis and n. intercostobrachialis in a patient with severe vascular pathology with lack of sensitivity and movements in the hand. The authors describe this technique in detail. </span></p> R. P. Chaplinsky, O. Yu. Perepelitsa, E. E. Perepelitsa, M. V. Levy, A. V. Omelchenko-Seliukova ##submission.copyrightStatement## Wed, 07 Mar 2018 00:00:00 +0200 Lumbar spinal stenosis: symptoms, diagnosis and treatment (meta-analysis of literature data) <p><span style="background-color: #ffffff;">Lumbar spinal stenosis is a disease in which degenerated discs, ligamentum flavum, facet joints, while aging, lead to a narrowing of the space around the neurovascular structures of the spine. This article presents a meta-analysis of literature data on epidemiology, causes, pathogenesis, diagnosis and various types of treatment of lumbar spinal stenosis. </span></p> Ia. V. Fishchenko, L. D. Kravchuk, O. A. Perepechay ##submission.copyrightStatement## Wed, 07 Mar 2018 00:00:00 +0200 Complex approach to treatment of the carpal tunnel syndrome, with the use of methods of manual therapy <p><span style="background-color: #ffffff;">42 people with diagnosed carpal tunnel syndrome were examined. It was found that in the complex treatment of carpal tunnel syndrome, along with standard therapy in the form of preparations of alpha-lipoic acid and pentoxyfylline, there are effective mobilization and traction techniques of the wrist, elbow joint, as well as post-isometric relaxation of m. deltoideus, m. infraspinatus, m. supraspinatus, m. minor and major teres, m. subscapularis, m. pectoralis minor.</span></p> V. A. Yevdokymov, O. V. Romaliyskaya ##submission.copyrightStatement## Wed, 07 Mar 2018 00:00:00 +0200 Vertebral instability of lumbar spine and its neurological presentations <p><span style="background-color: #ffffff;">&nbsp;Background. </span></p> <p><span style="background-color: #ffffff;">The research results of data of 57 patients with vertebral instability of lumbar spine with neurological presentations are presented. Patients were on in-patient treatment at the Vertebral surgery department of Institute of Traumatology and Orthopedics (Kyiv) in 2010–2014. </span></p> <p><span style="background-color: #ffffff;">Research object. </span></p> <p><span style="background-color: #ffffff;">The aim of the research was to determine the features of clinical signs and X-ray measures depending on type and stage of instability in lumbar spine. </span></p> <p><span style="background-color: #ffffff;">Materials and methods. </span></p> <p><span style="background-color: #ffffff;">The research is based on the analysis of management of 57 patients with lumbar spine instability. The management consisted of anamnesis, examination of patients, X-ray of spine, MRI and CT. The majority of patients were males. There were 35 (61.4 %) males, 22 (38.6 %) females among all of the patients. Due to the data of the research it was inquired that the spine instability was detected frequently in the most employable age, from 20 to 44 years – 30 (52.6 %) cases. </span></p> <p><span style="background-color: #ffffff;">Results and discussion. </span></p> <p><span style="background-color: #ffffff;">The spine instability is clinical and radiographic manifestation of pathological removability of contiguous vertebras due to each other. This resulted in lesion of vertebras and adjoined vessels and nerves, caused by inadequate supporting system of spinal motion segments. Failure of spinal motion segments develops mainly in degenerative and dystrophic disorders resulted in acute or chronic congestions influenced by microtraumas. Development of secondary lesions of spine and spinal radixes are affected by deformation of spine and spinal channel. Emerging of pathological processes is accompanied by orthopedic and neurological presentations, that requiring surgical correction. </span></p> <p><span style="background-color: #ffffff;">Conclusions. </span></p> <p><span style="background-color: #ffffff;">Instability of VMS is caused by structure alteration of intervertebral discs, aquatics and processes joints and a part of vertebral arc between joints. Clinical signs depend on the level of localization and the stage of spine instability. Among patients with spine instability the manifestation of radixes lesions were on the 1st place – 29 (50.9 %) cases, on the 2nd place – lesions of lumbago – 19 (33.3 %) cases. X-ray features of instability are: enlargement of linear displacement of vertebral body in sagittal plane more than 4.5 mm, segmental axial rotation of vertebra – more than 40°. </span></p> A. M. Vitkovskyi ##submission.copyrightStatement## Wed, 07 Mar 2018 00:00:00 +0200 Multimodal perioperative analgesia with minimally invasive interventions on the mammary gland <p><span style="background-color: #ffffff;">The article presents the study of the use of parenteral forms of drugs Infulgan and Nalbuphine on the base of the Regional Mammological Center and the Department of Anesthesiology N 1 of Clinical Oncology Dispensary (Dnipro). We have generalized the experience of using these agents as part of multimodal perioperative analgesia in 15 patients who underwent a vacuum aspiration biopsy of the mammary gland using the “Mammotome HH” device. We assessed the intensity of pain in the postoperative period and the need for additional anesthesia. The results of the study showed that the pre-emptive multimodal analgesia with the use of par cetamol in the form of an infusion of Nalbuphine was effective and safe for perioperative analgesia in outpatient minimally invasive diagnostic and therapeutic operations on breast tissue. Such anesthesia made it possible to reduce the doses of anaesthetics used in the postoperative period, facilitating the return of patients to a full life after breast vacuum aspiration biopsy. Our experience may be recommended for relief of the pain syndrome after minimally invasive surgery interventions. </span></p> D. E. Korenyuk, A. G. Tkachuk, Yu. M. Terzi, V. Ya. Lagunov, A. G. Antonenko, E. V. Kolokolnikova ##submission.copyrightStatement## Wed, 07 Mar 2018 00:00:00 +0200 Efficiency of the combination of physical therapy modalities with topical nonsteroidal anti-inflammatory drugs for treatment of pain in rheumatology <p><span style="background-color: #ffffff;">Pain is the most common syndrome in rheumatology. NSAIDs are often used in its treatment. But they have limitations associated with side effects. An advantage of topical drugs and physical factors (electrophoresis, phonophoresis) combination is the use of low doses of the drug and a decrease in time, to achieve a therapeutic effect, reduce the risk of adverse reactions, increase the concentration of the drug in the inflammation focus, prolonged action (creating a drug depot in tissues). Ketoprofen gel (“Artrocol gel”) is one of the representatives of this pharmacological group. Physicochemical properties help ketoprofen to penetrate easily through the skin and create a therapeutic concentration in the underlying tissues. </span></p> <p><span style="background-color: #ffffff;">O</span><span style="background-color: #ffffff;">bjective. </span></p> <p><span style="background-color: #ffffff;">To assess the effectiveness of ketoprofen gel (“Arthrocol gel”) electrophonophoresis in the treatment of pain in rheumatological patients. </span></p> <p><span style="background-color: #ffffff;">Materials and methods. </span></p> <p><span style="background-color: #ffffff;">The study was carried out on the basis of Physiotherapy Department of Vinnytsia Regional Clinical Hospital named after M. I. Pirogov. All patients treated according to the unified clinical protocols were divided into experimental group (EG) and control group (CG). Patients of EG (98 persons) underwent electrophonophoresis with ketoprofen gel once a day for a week. In CG (43 persons) ketoprofen gel was used without electrophonophoresis. The intensity of the pain syndrome is monitored using a visual analog scale (VAS) of Huskisson at rest and during movement. A week later, the patient and the doctor evaluated satisfaction with the results of treatment on the scale: not effective, insufficient, satisfactory, good, excellent. </span></p> <p><span style="background-color: #ffffff;">Results. </span></p> <p><span style="background-color: #ffffff;">There was a persistent decrease in the intensity of pain syndrome in patients of both groups. The VAS scores were lower in the EG starting from the 3rd day of treatment. The intensity of the acute pain syndrome after 1-week treatment at rest (t = 4.71, p &lt; 0.001) and during the movement (t = 3.84,&nbsp; p &lt; 0.001) more decrease in EG. Satisfaction with the results of treatment was higher in EG. </span></p> O. A. Kapeltsova, O. V. Dolynna, N. V. Shkolina, O. V. Marchuk ##submission.copyrightStatement## Wed, 07 Mar 2018 00:00:00 +0200 Kinesiotaping as one of the methods of treatment of low back pain syndrome <p><span style="background-color: #ffffff;">About 80 % of adults feel pain in their backs at a definite moment of life. That’s also the most frequent reason why people lose their efficiency. It’s also the key factor due to which workable people miss their working days. Recently, the frequency of sickness rate of low back pain syndrome is getting higher and higher. For examples, according to the data of the organization, which aims at analyzing pathological conditions and diseases, which cause death or looseness of efficiency, in 1990 in the USA, low back pain syndrome took the sixth place, but in 2010 back pain went up to the third place, giving the way only to ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD). So, we can imagine how common, widespread and serious for modern world became the problem of back pain. That’s why, only now doctors throughout the world are starting to form their separate individual researches into one qualitative and useful list of recommendations to begin an effective fight with this serious medical and social problem. Kinesiotaping (“kinesio” – movement + “tape”) – is an effective treatment and rehabilitation method of muscle and joints injuries with the help of special elastic tapes – namely kinesio tapes. The article focuses on the method of kinesiotaping and the ways of its usage for treating low back pain syndrome. The research also highlights the history of appearance and development of kinesiotaping as a method of treatment, physiological features of kinesio tape and ways of its usage in everyday medical practice. Besides analyzing recent researches in this field we provide descriptions of three clinical cases from our own medical practice which proves the effectiveness of kinesiotaping in the complex treatment of low back pain syndrome. After deep analysis of the patients’ condition we can state that due to kinesiotaping which is used together with other physiotherapeutic methods and exercises, they recover quickly than those who do not undergo kinesiotaping procedures. </span></p> D. V. Babelyuk, Y. M. Polihas ##submission.copyrightStatement## Wed, 07 Mar 2018 00:00:00 +0200 Prophylaxis of the pain of the syndrome when using removable dentures <p><span style="background-color: #ffffff;">Orthopedic dental treatment can be accompanied by pain of different nature, violation of sensitivity and appearance of various paresthesia (burning, itching, tingling, numbness, etc.). Dentures are an irritant for tissues of the oral cavity, namely, its excessive pressure in certain areas of the prosthetic bed. It is well known that a large number of patients using removable dentures can not get used to them because of pain. The goal of our research is to improve the method of preventing pain syndrome with the use of removable dentures, whereby by making changes to the special preparation for prosthetics and the means of preventing inflammatory conditions, conditions are created to prevent the pain syndrome and increase the sensitivity threshold of the mucous membrane of the prosthetic field. According to the results of the study, it was found that the use of auricular microhole therapy, carried out by cycles of 7 days, with an interval of 5 days, leads to a decrease in pain sensitivity of the mucous membrane of the alveolar processes and palate to the norm parameters, which in turn significantly reduces and facilitates the period of adaptation to complete removable prostheses. </span></p> M. Ya. Nidzelsky, N. V. Tsvetkova, V. M. Sokolovskaya ##submission.copyrightStatement## Wed, 07 Mar 2018 00:00:00 +0200