The Role of Adjuvants in Pain Syndrome Therapy

The Department of Nervous Diseases of KazNMU named after S.D. Asfendiyarov continues its series of educational events for healthcare practitioners dedicated to the 95th anniversary of our esteemed university and the 90th anniversary of Professor S.K. Kaishibaev’s memory.

On February 20, a webinar on the topic “The Role of Adjuvants in Pain Syndrome Therapy” was held for neurologists, general practitioners, therapists, and residents. The webinar was conducted by the Head of the Department of Nervous Diseases at KazNMU, Chief Neurologist of the Ministry of Health of the Republic of Kazakhstan, Turupekova S.T.

The definition of pain provided by experts from the International Association for the Study of Pain is as follows: “An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”

Pain can occur not only due to tissue damage but even in the absence of any damage, highlighting the significant role of psychological factors in the formation and maintenance of pain.

Pain syndromes occupy a predominant position in the structure of neurological and rheumatological diseases. Pain is the most common reason for patients seeking emergency medical care—accounting for 52% of cases. However, 30% to 80% of patients do not receive adequate pain relief.

Back pain remains a leading cause in the structure of non-infectious diseases regarding years of life lost due to persistent health deterioration. It is one of the most common complaints among working-age individuals. Throughout life, dorsalgia occurs in 70–90% of the population in developed countries and is noted annually in 20–25% of people. Dorsalgia, or back pain, is a clinical syndrome caused by various factors. Pain can result from diseases and injuries of the discs (disc protrusion, herniation) and intervertebral joints (facet joint osteoarthritis), among other conditions.

The number of people experiencing back pain has risen dramatically in recent decades, making it the most common complaint worldwide. Most domestic and international studies indicate no clear link between the severity of degenerative-dystrophic morphological changes in the spine and the presence or intensity of back pain. Notably, MRI findings of intervertebral disc pathology are often observed in healthy individuals, and clinical studies have repeatedly shown that detecting pathological changes in intervertebral discs does not necessarily predispose individuals to back pain over time. Importantly, inadequate or delayed treatment of acute pain can lead to its transformation into chronic pain and the development of pain behavior, perpetuating and sustaining the pain cycle, ultimately leading to patient maladaptation.

What is an Adjuvant?

The term translates to “helping” or “supporting.” In other words, it refers to a substance or combination of substances used to enhance a response. Adjuvant therapy can have two meanings:

1. Serving as assistance or support: auxiliary.
2. Enhancing the effectiveness of medical treatment.

The first use of adjuvant therapy was by American oncologist Emil Frei in the early 1970s. He administered a course of postoperative chemotherapy to a patient with bone sarcoma. The experiment was successful, and today adjuvant therapy is part of treatment protocols for many oncological diseases.

In modern medicine, adjuvant medications are an integral part of pain syndrome therapy, helping to increase treatment effectiveness, reduce the dosage of primary analgesics, and minimize side effects. During the event, Saule Turuspekova provided a detailed explanation of the mechanisms of action of adjuvants, their role in comprehensive pain management, and their application for various pathological conditions.

Key questions discussed included:

• What groups of drugs are considered adjuvants, and how do they work?

• When and for whom should adjuvant therapy be prescribed?

• Current scientific data and clinical guidelines on the use of adjuvants.

The webinar was attended live by 80 specialists from various regions, and a recording of the webinar is also available for viewing.

The webinar was held with informational support from Unipharm and the MedQ Kazakhstan platform.