[Current state of algology - pain medicine - in the Russian Federation].

Objective: To analyze the structure of care for patients with pain syndromes in the Russian Federation and possible improvement of these approaches.

Material and methods: A detailed questionnaire was sent to 60 pain clinics. We received responses from 40 hospitals. Other information was obtained from annual statistical reports for 2021-2023. Fifteen clinics and departments in different regions were inspected.

Results: A total of 3871 implantations of test electrodes and 2317 systems for permanent neurostimulation were performed in the Russian Federation in 2021-2023. There were 30-110 annual implantations in Moscow and St. Petersburg clinics, as well as 5-30 procedures in other hospitals. The indications for stimulation system implantation were persistent back pain syndrome (58%), complex regional pain syndrome (12.5%), spasticity (9%), chronic pelvic pain (7.5%), critical lower limb ischemia (6%), peripheral neuropathies (5%), refractory angina (1%), etc. (1%). About 3700 patients seek treatment in pain departments and clinics annually. Of these, 49% were referred for interventional treatment (blockades, radiofrequency ablation), 7% - for neuromodulation.

Discussion: Extrapolation of the International Association for the Study of Pain (IASP) data suggests that 548.000 people in the Russian Federation suffer from neuropathic pain refractory to drug therapy. The need for pain surgery is 27.400 interventions per year. In the Russian Federation, there is no multiple-level medical care for severe pain syndromes. It is difficult to realize a comprehensive interdisciplinary approach to diagnosis, treatment and rehabilitation of patients who suffer and often become disabled only because of severe chronic pain.

Conclusion: It is necessary to distinguish algology as a separate specialty and contribute to development of this extremely important area of medicine.