[Features of the clinical picture, diagnosis and treatment of pain syndromes formed on the basis of combined lesions of the spine in the elderly and senile age.]

Based on the long-term observation of 105 representatives of the elderly and senile age, the features of the clinical picture of pain syndromes formed in the elderly and senile age on the basis of combined spinal lesions in osteoporosis and spondylarthrosis are presented, and methods of diagnosis and treatment of such patients are proposed. The main variants of symptoms developing in response to long-term tonic muscle tension in degenerative age-dependent injuries of vertebral bodies, intervertebral discs and facet joints at the level of thoracic and lumbosacral spine are shown. Pathogenetic connections of frequent urination disorders in the elderly and senile age with pathological processes in the spine and muscular-tonic pain syndromes were determined. In pathological muscle hyperactivity, accompanied by pain syndromes, restrictions of movements in the spine and the formation of pathological poses, it is recommended to use in the treatment of soft techniques of manual therapy and botuline toxin therapy, and with distinct structural, anatomical defects of vertebral segments - local corticosteroid therapy.

[Age aspects of the muscular-tonic and urological syndromes in men with disorders of the pelvic functions: the features of clinic, diagnostics, treatment].

A comparative examination of 100 patients at different ages, suffering from disorders of micturition, erectile function and pelvic pain, identified age-related peculiarities of these pathological manifestations. Irritative disorders of urination was detected significantly more frequently among persons of young and middle age than the elderly, and obstructive-related disorders were more frequent in the elderly. In elderly and senile age more prevalent was reducing of the contractility of the detrusor, and at a younger age - increased tone of striated sphincter of the urethra and bladder hyperactivity. It was shown that the participation of long-existing spasm of some muscle formation of the lumbar, pelvic and femoral region in the genesis of urinary symptoms, erectile dysfunction and pelvic pain. When using manual therapy, physiotherapy and botuline-therapy high effectiveness against disorders of micturition, erectile function and pelvic pain was achieved regardless of the age of the patients. It is recommended for the diagnosis of urological pathology to involve specialists in the field of neurology and manual therapy. In cases of diagnosis of musculo-tonic disorders not etiologically associated with pathological processes in the organs of the urogenital system, in the complex of therapeutic measures it is recommended to include methods such as manual-therapy, physiotherapy, botuline-therapy.