Walking instead of pills: a new behavioral therapy for pain relief has been named

Russians don’t know about this and continue to drink painkillers in packs

Russian patients take painkillers very lightly. According to a recently conducted STADA Health Report 2023 study among 2 thousand respondents, every second Russian surveyed takes such drugs more than once a month, every third – monthly, 27% – weekly, and 4% – every day!

Meanwhile, as experts said during the scientific and practical conference “Medicine for the Elderly,” today world medicine views pain as a psychosocial phenomenon – most often it is a play of our imagination, and therefore does not require medication.

Pain is one of the most common complaints when visiting doctors. According to the professor, head of the laboratory of diseases of the musculoskeletal system of the Russian Gerontological Research and Clinical Center of the Russian National Research Medical University named after. Pirogova Anton Naumov, a recent large-scale study among 1.3 million patients in clinics showed that everyone came in for pain (and 60% complained of back pain). More than 90% of the population has back pain at least once a year, 48% have it once a week, and 34% have it every day (this was shown by a survey among 19 thousand Europeans). Meanwhile, among the 10 leading medical causes that reduce the number of healthy years of life, back pain ranks first (depression and iron deficiency anemia come in second and third). In addition, studies have shown a 20% increase in the risk of cardiovascular events in patients experiencing pain.

“Pain is a tricky game of the mind and our imagination. The world has declared pain a psychosociological phenomenon,” says Professor Naumov.

Doctors cannot always reach the cause of pain (for example, a survey among European doctors showed that it is not determined in 50% of cases). According to the latest data, the cause of back pain, especially in elderly patients, is vitamin D deficiency – after eliminating the cause, the pain goes away. And the first thing prescribed to such patients is vitamin therapy. Secondly, physical therapy, lumbar corset, shoe insoles, workplace optimization are prescribed… Pain is one of the leading factors in the onset and progression of senile asthenia; in the presence of pain, the risks increase threefold. Any painful sensations entail an increase in energy costs for muscle work, and the brain responds by prohibiting the muscles from moving. Therefore, a person begins to decrease physical activity. So, as doctors say, when there is pain, you just need to make the patient move!

And only when all this does not help, we should talk about pain relief with the help of painkillers. At the same time, Anton Naumov admits that only with their help, as well as with the help of drugs from the nonsteroidal anti-inflammatory drugs (NSAIDs) group, it is impossible to overcome the pain syndrome. In some cases, anticonvulsants and antidepressants are now prescribed to relieve pain. For example, depression is the most common cause of lower back pain.

“Patient complaints are not always a marker of pain. Today there are questionnaires that allow you to evaluate it even without direct complaints of pain. But, since pain is a biopsychosocial phenomenon, the patient will feel it exactly as much as he imagines it. Dialogue with the patient is of great importance in pain therapy. After all, the main task is to change a person’s perception of it, only then can we achieve effectiveness in the fight against it.”

Regarding the high prevalence of self-use of painkillers among Russians, the expert warns that these drugs have a huge number of side effects: “The risk of developing undesirable effects is primarily associated with damage to the gastrointestinal mucosa. In second place is the increased risk of heart attacks and strokes with long-term uncontrolled use, especially in patients with high and very high vascular risk. In addition, one in four patients taking these drugs develops kidney damage. A recently verified study of EUCALYPTUS among 4.3 thousand patients from 11 regions of the country among patients over 65 years of age showed that every second of them takes non-steroidal anti-inflammatory drugs once a week or daily.”

Based on the concept that pain is a game of the mind, cognitive behavioral therapy is recognized as the most effective method of treating pain in the world. But Professor Naumov admits that there are very few specialists in the country who know this technique, so there is often virtually nowhere to refer patients with pain. As a result, they are recommended to consult with psychotherapists, but these specialists rarely master the mentioned technique, because this is the competence of neurologists and psychiatrists who can be trained in this method.