geriatrРоссийский журнал гериатрической медициныRussian Journal of Geriatric Medicine2686-86362686-8709Сайт издателя10.37586/2686-8636-3-2021-360-363geriatr-207Research ArticleКЛИНИЧЕСКИЙ РАЗБОРCLINICAL CASESКлинический случай пациента с хроническим болевым синдромомA patient with chronic pain syndromehttps://orcid.org/0000-0001-6040-1090МорозВ. И.MorozV. I.

Москва

Moscow

https://orcid.org/0000-0003-1969-8923БалаеваМ. М.-Б.BalaevaM.. B.

Москва

Moscow

https://orcid.org/0000-0002-6253-621XНаумовА. В.NaumovA. V

Наумов Антон Вячеславович, д.м.н., заведующий лабораторией заболеваний костно-мышечной системы ОСП, профессор кафедры болезней старения

Москва

Naumov Anton Vyacheslavovich, MD, PhD, Professor, head of the laboratory of diseases of the musculoskeletal system

Moscow

https://orcid.org/0000-0002-3066-4866ХовасоваН. О.KhovasovaN. O.

Ховасова Наталья Олеговна, к.м.н., доцент кафедры болезней старения, старший научный сотрудник лаборатории заболеваний костно-мышечной системы ОСП

Москва

Khovasova Natalia Olegovna, PhD, senior researcher of the laboratory of diseases of the musculoskeletal system

Moscow

ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России, Российский геронтологический научно-клинический центрРоссияPirogov Russian National Research Medical University of Ministry of Health of the Russian Federation, Russian Gerontology Research and Clinical CentreRussian Federation20211510202103368371Copyright © Мороз В.И., Балаева М.М., Наумов А.В., Ховасова Н.О., 20212021Мороз В.И., Балаева М.М., Наумов А.В., Ховасова Н.О.Moroz V.I., Balaeva M.B., Naumov A.V., Khovasova N.O.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.geriatr-news.com/jour/article/view/207

В статье описан клинический случай пациента с хроническим болевым синдромом на фоне остеоартрита, с эндопротезированием суставов в анамнезе. Поводом для госпитализации послужило падение, после чего сохранялся постоянный некупируемый болевой синдром. В результате комплексной гериатрической оценки у пациентки дополнительно выявлен синдром старческой астении, легкая зависимость от посторонней помощи, нарушения баланса, синдром падений, стрессовое недержание мочи. Были рекомендованы немедикаментозные методы лечения и комплексная терапия (габапентин + витамины группы В + уридин), а также антиостеопоротическая терапия, на фоне чего интенсивность болевого синдрома снизилась до легкой степени (по шкале ВАШ 2 балла на момент выписки) и отмечено уменьшение копаттернов нейропатии.

This article describes a clinical case of a patient with chronic pain syndrome on the background of osteoarthritis, with a history of joint replacement. The reason for hospitalization was a fall, after which a constant pain syndrome persisted and a neuropathic component joined, which the patient could not stop with anything.As a result of a comprehensive geriatric assessment, the patient was diagnosed with frailty and the following geriatric syndromes: mild dependence on outside help, chronic pain syndrome, balance disorders, falls, stress urinary incontinence. Non-drug methods of treatment and complex therapy (gabapentin + B vitamins + uridine) and antiosteoporetic therapy were recommended, against which the intensity of the pain syndrome decreased to a mild degree (according to the VAS scale of 2 points at the time of discharge) and a decrease in neuropathy copatterns was noted.

гериатрический синдромпаденияхроническая больстарческая астениянейропатияостеоартритэндопротезированиеgeriatric syndromefallschronic painfrailtyneuropathyosteoarthritisendoprostheticsReferencesНаумов А.В., Мороз В.И., Ховасова Н.О., Маневич Т.М., Балаева М.М., Деменок Д.В., Ткачева О.Н. Хроническая боль в пожилом возрасте: фокус на саркопению. Медицинский Совет. 2019; (12): 106–114.Наумов А.В., Мороз В.И., Ховасова Н.О., Маневич Т.М., Балаева М.М., Деменок Д.В., Ткачева О.Н. Хроническая боль в пожилом возрасте: фокус на саркопению. Медицинский Совет. 2019; (12): 106–114.Anand K.J., Craig K.D. New perspectives on the definition of pain. PAIN. 1996; 67: 3–11.Anand K.J., Craig K.D. New perspectives on the definition of pain. PAIN. 1996; 67: 3–11.Vos T., Allen C., Arora M. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017; 390: 1211–1259.Vos T., Allen C., Arora M. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017; 390: 1211–1259.Fayaz A., Croft P., Langford R., Donaldson J., Jones G. Prevalence of chronic pain in the UK: a systematic review and metaanalysis of population studies. BMJ Open. 2016; 6.Fayaz A., Croft P., Langford R., Donaldson J., Jones G. Prevalence of chronic pain in the UK: a systematic review and metaanalysis of population studies. BMJ Open. 2016; 6.Thomas E. In: Chapter 4: Chronic pain epidemiology. Croft P., Blyth F.M., van der Windt D., editors. Oxford University Press; Oxford: 2010. p. 185.Thomas E. In: Chapter 4: Chronic pain epidemiology. Croft P., Blyth F.M., van der Windt D., editors. Oxford University Press; Oxford: 2010. p. 185.Docking R., Fleming J., Brayne C. Epidemiology of back pain in older adults: prevalence and risk factors for back pain onset. Rheumatology. 2011; 50: 1645–1653.Docking R., Fleming J., Brayne C. Epidemiology of back pain in older adults: prevalence and risk factors for back pain onset. Rheumatology. 2011; 50: 1645–1653.Thomas E., Peat G., Harris L., Wilkie R., Croft P.R. The prevalence of pain and pain interference in a general population of older adults: cross-sectional findings from the North Staffordshire Osteoarthritis Project (NorStOP) Pain. 2004; 110: 361–368.Thomas E., Peat G., Harris L., Wilkie R., Croft P.R. The prevalence of pain and pain interference in a general population of older adults: cross-sectional findings from the North Staffordshire Osteoarthritis Project (NorStOP) Pain. 2004; 110: 361–368.Barnett K., Mercer S.W., Norbury M., Watt G., Wyke S., Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012; 380: 37–43.Barnett K., Mercer S.W., Norbury M., Watt G., Wyke S., Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012; 380: 37–43.Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. Br J Anaesth. 2019; 123(2): e273–e283. DOI: 10.1016/j. bja.2019.03.023.Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. Br J Anaesth. 2019; 123(2): e273–e283. DOI: 10.1016/j. bja.2019.03.023.Smith D., Wilkie R., Uthman O., Jordan J.L., McBeth J. Chronic pain and mortality: a systematic review. PloS One. 2014; 9.Smith D., Wilkie R., Uthman O., Jordan J.L., McBeth J. Chronic pain and mortality: a systematic review. PloS One. 2014; 9.Macfarlane G., Barnish M., Jones G. Persons with chronic widespread pain experience excess mortality: longitudinal results from UK Biobank and meta-analysis. Ann Rheum Dis. 2017; 76.Macfarlane G., Barnish M., Jones G. Persons with chronic widespread pain experience excess mortality: longitudinal results from UK Biobank and meta-analysis. Ann Rheum Dis. 2017; 76.Ткачева О.Н. и др. Хроническая боль у пациентов пожи- лого и старческого возраста. Клинические рекомендации 2020.Ткачева О.Н. и др. Хроническая боль у пациентов пожи- лого и старческого возраста. Клинические рекомендации 2020.Blyth F.M., Noguchi N. Chronic musculoskeletal pain and its impact on older people. Best Pract Res Clin Rheumatol. 2017 Apr; 31(2): 160–168. DOI: 10.1016/j.berh.2017.10.004. Epub 2017 Nov 4.Blyth F.M., Noguchi N. Chronic musculoskeletal pain and its impact on older people. Best Pract Res Clin Rheumatol. 2017 Apr; 31(2): 160–168. DOI: 10.1016/j.berh.2017.10.004. Epub 2017 Nov 4.Кукушкин М.Л., Хитров Н.К. Общая патология боли. И. Медицина 2004. 144.Кукушкин М.Л., Хитров Н.К. Общая патология боли. И. Медицина 2004. 144.Sanada F., Taniyama Y., Muratsu J. et al. Source of Chronic Inflammation in Aging. Front Cardiovasc Med. 2018; 5: 12.Sanada F., Taniyama Y., Muratsu J. et al. Source of Chronic Inflammation in Aging. Front Cardiovasc Med. 2018; 5: 12.Nikas J.B. Inflammation and Immune System Activation in Aging: A Mathematical Approach. Sci. Rep. 2013; 3: 3254.Nikas J.B. Inflammation and Immune System Activation in Aging: A Mathematical Approach. Sci. Rep. 2013; 3: 3254.Shega J.W., Dale W., Andrew M., Paice J., et al. Persistent pain and frailty: a case for homeostenosis. J Am Geriatr Soc. 2012; 60: 113–117.Shega J.W., Dale W., Andrew M., Paice J., et al. Persistent pain and frailty: a case for homeostenosis. J Am Geriatr Soc. 2012; 60: 113–117.

The authors declare that there are no conflicts of interest present.