OBJECTIVE

Evaluation of Alfultop impact on nociceptive afferentation central mechanisms in patients with chronic lower back pain.

MATERIALS AND METHODS

The study involved 40 patients with CLBP. The therapy included Alflutop, 2 ml once a day for 10 days. Mean VAS-pain, LANSS, Roland-Morris questionnaire, Global Rating of Change Scale (GRC), pressure pain thresholds data were analyzed. Follow-up duration was 3 months.

RESULTS

Most of the patients were females (f:m=1.3:1); average age — 60.5 [54.2; 67.3] years with a mean disease duration of 14.3±4.2 mo. At visit 1, the VAS score was 63.2±9.4, LANSS 14.2±2.1 points, and the Roland-Morris questionnaire 9.9±3.5 points. There was a significant decrease in the pain threshold both in the zone of maximum pain, located in the lower back (3.97±0.9 kg/sm²), and in suprasegmental area (5.22±1.7 kg/sm²), and a pathological change in the temporal summation of pain (789.2±45.6 mm). After Alflutop therapy, significant changes in the parameters of the VAS, LANSS and Roland-Morris scores were recorded after 30 days of observation and maximum changes in 3 months. The pain threshold has significantly increased after 3 months of observation. The majority of patients rated the improvement from the therapy as «moderate» and «pronounced» (33/82.5%) according to the GRC scale. A significant relationship was established between the level of pain threshold and the intensity of pain on the VAS scale (R=0.714), its duration (R=0.799) and disability of the patients (R=0.706).

CONCLUSIONS

Central sensitization develops in patients with CLBP, which correlates with VAS score of pain intensity, its duration and the degree of disability. Alflutop significantly reduces the intensity of the pain syndrome, its neuropathic component, significantly increases the level of pain threshold and improves the disability of patients in 3 months after the start of treatment.