Rehabilitation of elderly and senile patients with chronic pain syndrome due to deforming dorsopathy

BACKGROUND. Chronic pain syndrome in dorsopathy is a common geriatric syndrome diagnosed in 65% of patients aged 60 to 75 years. It impairs the quality of life in older adults and leads to anxiety and depressive disorders due to persistent symptoms [22]. This necessitates introducing non-pharmacological rehabilitation methods into the treatment plan for this group of patients. It will help avoid polypharmacy and its cumulative side effects and improve patients’ functional abilities, self-care, and capacity for daily and occupational activities.

AIM. To scientifically substantiate the effectiveness of rehabilitation measures for chronic lower back pain syndrome in elderly and senile patients with dorsopathy using non-pharmacological treatment methods, in particular therapeutic physical exercises, physiotherapy, individualized orthopedic support, etc.

MATERIAL AND METHODS. The study included 120 patients diagnosed with deforming dorsopathy, with a mean age of 67.1 (66.8; 67.4) years, of whom 71 (59%) were female. The patients were divided into two groups: the main group (n=66) and the control group (n=54). The main group of elderly patients received continuous year-round treatment focusing on non-pharmacological methods (therapeutic physical exercises, individualized orthopedic corrections, physiotherapy, etc.). In contrast, the control group received treatment once every six months, mainly focusing on pharmacotherapy as the basis of treatment. Rehabilitation effectiveness was evaluated before and after treatment (after one calendar year) using the  EQ-5D-5L quality of life questionnaire, a visual analog scale for pain, assessments of general motor activity, self-care skills, ability to perform work, emotional and volitional characteristics, and the severity of main somatic complaints.

RESULTS. This study showed the effectiveness of continuous year-round use of non-pharmacological treatment methods (including dosed physical activity tailored to disease periods as a foundation) supplemented by medication when necessary during acute phases. The results indicate that consistent use (throughout the calendar year) of kinesitherapy, individualized foot orthotics, and physiotherapy (if clinically necessary) significantly improves the somatic status of patients, (reduces the need for pain relief medication, lessens dependence on constant assistance, improves quality of life, and positively affects emotional and volitional qualities, such as mood and initiative).

CONCLUSION. The preventive introduction of the proposed therapeutic methods could help primary care physicians and neurologists to alleviate pain symptoms faster, improve the quality of life in this cohort of patients, and reduce the frequency of hospitalizations, which is of significant economic importance for healthcare system as a whole.

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