RADICULAR PAIN SYNDROME: CLINICAL AND DEMOGRAPHIC CHARACTERISTICS, RISK FACTORS, DIAGNOSIS, AND EFFECTIVENESS OF COMPREHENSIVE CONSERVATIVE THERAPY AND REHABILITATION

Abstract

Introduction. Radicular pain syndrome (RPS) is one of the leading causes of temporary disability among working-age individuals, particularly those engaged in heavy physical labor. The specificity of occupational load contributes to accelerated degeneration of intervertebral discs, while traditional criteria for assessing treatment efficacy do not adequately reflect functional outcomes. Aim. To summarize the results of a comprehensive study of the clinical and demographic features, risk factors, diagnosis, conservative therapy, algorithms for acute pain relief, and rehabilitation of RPS with a focus on preserving work capacity and quality of life. Materials and methods. In 2024–2025, 120 men aged 19–45 years with vertebrogenic RPS of lumbosacral localization were examined (retrospective and prospective, randomized comparative, and cross-sectional designs). Pain was assessed using the visual analog scale (VAS), functional status – using the Oswestry Disability Index (ODI); MRI and electroneuromyography (ENMG) were applied. Results. The leading risk factors were lifting heavy loads (>25–30 kg), vibration (herniation risk increased 2.4-fold), and physical inactivity. Discrepancy between clinical and MRI levels of lesion was found in 28% of cases, subclinical denervation – in 14%. Conservative therapy provided ≥50% improvement in VAS in 88.3% of patients; surgery was required in 3.3%. The optimized algorithm increased return to work by day 5 from 45% to 82%. Individualized rehabilitation increased the strength of back extensor muscles by 45.6% (versus 18.2%) and ensured readiness for full load in 95% of patients. Conclusion. The results justify the implementation of comprehensive protocols for diagnosis, treatment, and rehabilitation of RPS aimed at preserving work capacity.