Danilov Andrey, Danilov Alexey, Badaeva Anastasiia, Kosareva Anastasiia, Popovskaya Ksenia, Novikov Viacheslav
Department for Nervous Diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119991, Moscow, Russia.
Department for Pathological Physiology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119991, Moscow, Russia.
Pain Ther. 2025 Apr;14(2):479-496. doi: 10.1007/s40122-025-00706-w. Epub 2025 Jan 29.
Chronic non-specific low back pain (CNSLBP) is a debilitating condition that affects millions of people worldwide, significantly impacting quality of life and imposing a substantial socioeconomic burden. Traditional treatment approaches often rely on a one-size-fits-all strategy, failing to account for individual variations in pathophysiological mechanisms, drivers, and the principles of personalized medicine. Furthermore, an overemphasis on biomechanical findings from imaging may lead to ineffective interventions and unnecessary surgical procedures, obscuring other important factors that contribute to pain perception. While highlighting the limitations of universal treatment approaches, in this review we present a practical clinical approach aimed at elucidating the main pathophysiological mechanisms and various factors underlying the development and maintenance of CNSLBP in order to create a personalized treatment program. In conclusion, this review underscores the need for personalized therapeutic strategies that take into account the unique characteristics of each patient, recognizing the complex interaction of biological, psychological, social, and other factors that contribute to the development of individual pain. By combining a comprehensive understanding of the complexities of this condition, we aim to improve clinical outcomes and provide information on the development of effective personalized treatment algorithms, particularly in the field of neurological practice.
慢性非特异性下腰痛（CNSLBP）是一种使人衰弱的疾病，影响着全球数百万人，严重影响生活质量并带来巨大的社会经济负担。传统的治疗方法往往采用一刀切的策略，没有考虑到病理生理机制、驱动因素的个体差异以及个性化医疗原则。此外，过度强调影像学的生物力学结果可能导致无效的干预措施和不必要的手术，掩盖了其他导致疼痛感知的重要因素。在强调通用治疗方法局限性的同时，在本综述中，我们提出了一种实用的临床方法，旨在阐明CNSLBP发生和维持的主要病理生理机制及各种因素，以便制定个性化的治疗方案。总之，本综述强调了采取考虑每个患者独特特征的个性化治疗策略的必要性，认识到生物学、心理、社会和其他因素在个体疼痛发生过程中的复杂相互作用。通过综合理解这种疾病的复杂性，我们旨在改善临床结果，并提供有关有效个性化治疗算法开发的信息，特别是在神经学实践领域。
