TREATMENT OF PAIN IN DYSFUNCTION OF THE SACROILIAC JOINTS IN PATIENTS WITH ALGODYSMENORRHEA.
Keywords:
pain syndrome, algodysmenorrhea, sacroiliac joint dysfunction, anxiety disorders, local infiltration therapyAbstract
Formulation of the problem. The specificity of the pain syndrome in primary algodysmenorrhea causes such women to seek help not only from gynecologists but also from orthopedists-traumatologists, which requires the doctor to carefully diagnose and choose the optimal and effective treatment tactics.
Formulatiig the purpose of the article. The purpose of this article was to study the features of the development of pain in patients with algodysmenorrhea and dysfunction of the sacroiliac joints and to provide practical recommendations for treatment and rehabilitation tactics in this pathology.
Analysis of recent research and publications. The most common complaint of women with algodysmenorrhea, as evidenced by the scientific literature and confirm our observations, are colitis in the lower abdomen, lower back pain, low back pain. At the same time, psycho-somatic mechanisms are significantly involved in the pathogenesis of the pain syndrome, so in the process of treatment and rehabilitation of such patients it is necessary to take into account the psychological component.
Presenting main material. In this article, we have summarized the experience of providing medical and rehabilitation care to women with pain in the sacroiliac joint dysfunction associated with algodysmenorrhea, in the department of musculoskeletal rehabilitation, in the process of spa treatment. The study group included women aged 25-38 years (21 people, mean age 32.3 ± 6.9) with menstrual irregularities such as algodysmenorrhea and concomitant lower back pain due to dysfunction of the sacroiliac joint. Patients were divided into two groups with the same neuroorthopedic manifestations of the disease - the first group of 11 people, the second - 10. Psychodiagnostic and psychophysiological examination of these patients revealed the presence of anxiety in most of them, which led to the formation of internal picture of depressive-hypochondriac type. All patients underwent local treatment of sacroiliac pain by periarticular infiltrations of local anesthetics. Patients of the first group were given additional daily therapeutic gymnastics classes lasting 45 minutes according to their own developed program for pelvic instability. At the expressed pain syndrome connected with a course of the main disease, preference was given to exercises in an isometric mode.
Conclusions and prospects for further research. We have proven the high effectiveness of local topical infiltrative therapy in patients with algodysmenorrhea, in whom dysfunction of the sacroiliac joint was detected. When local therapy was combined with a course of therapeutic gymnastics aimed at stabilizing the pelvic bones, the results of treatment were better. According to the results of psychological testing, no significant improvement in the indicators of personal anxiety and mental asthenia, due to the impact of the underlying disease and requires psychotherapeutic treatment, but joining the therapy prescribed by gynecologists, therapeutic gymnastics and local infiltrative therapy reduces .
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