ABSTRACT

Back pain is a global public health problem characterised by high prevalence, significant economic burden and substantial impact on quality of life. Despite progress in understanding the pathophysiological aspects in the formation of back pain, the development of effective treatments remains a challenge.  The traditional approach, which considers back pain as a single disease, does not take into account its inherent clinical heterogeneity. Back pain phenotyping, based on the identification of subgroups of patients with common clinical characteristics, pathophysiological mechanisms and prognosis, represents a promising approach to personalised diagnosis and therapy. This article provides an overview of the current state of research on back pain phenotypes, highlighting different approaches to their identification. The new concept of D-TIMER phenotyping of back pain and the prospects for its use in the development of new diagnostic and therapeutic strategies are presented.

KEYWORDS: back pain, phenotypes, D-TIMER, Cocarnit, Tenoxicam

For citation: Rachin A.P., Sharov M.N., Parsamyan R.R., Rachin S.A., Prokofieva Y.S. Back Pain Phenotypes from the Perspective of the New D-TIMER Concept: from Clinical Heterogeneity to Personalised Therapy. Comorbidity Neurology. 2025; 2 (2): 72-81. https://doi.org/10.62505/3034-185x-2025-2-2-72-81

*For correspondence: Andrei P. Rachin, Dr. Sci. (Med.), Professor, President of the National Association of Experts in Comorbid Neurology, Moscow, Russia, e-mail: 7851377@gmail.com

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ADDITIONAL INFORMATION

Andrei P. Rachin, Dr. Sci. (Med.), Professor, President of the National Association of Experts in Comorbid Neurology, Moscow, Russia. E-mail: 7851377@gmail.com. ORCID: https://orcid.org/0000-0003-4266-0050

Mikhail N. Sharov,  Dr. Sci. (Med.), Professor, Professor of the Department of Therapy, Clinical Pharmacology and Emergency Medicine, Russian University of Medicine, Moscow, Russia. E-mail: 6112286@mail.ru. ORCID: https://orcid.org/0000-0001-9634-346X

Ruzanna R. Parsamyan, Ph.D. Sci. (Med.), Associate Professor of the Department of Neurology named after K.N. Tretyakova, Senior Researcher at the Department of Basic Research in Neurocardiology, Research Institute of Cardiology, Saratov State Medical University named after V.I. Razumovsky, Head of Clinic Pain, Saratov, Russia. E-mail: kvl.prr@mail.ru. ORCID: https://orcid.org/0000-0002-6509-5958

Sergei A. Rachin, Executive Director, National Association of Experts in Comorbid Neurology, Moscow, Russia. E-mail: Rachin.sergei@gmail.com. ORCID: https://orcid.org/0000-0001-9771-4621

Yulia S. Prokofieva, postgraduate student of the Department of Nervous Diseases, Faculty of Dentistry, Russian University of Medicine, Moscow, Russia. E-mail: pryulek@yandex.ru. ORCID: https://orcid.org/0000-0003-4454-7174

Author contributions. All authors confirm the compliance of their authorship, according to international ICMJE criteria (all authors made a significant contribution to the development of the concept, research and preparation of the article, read and approved the final version before publication).– searched for suitable literature;– correcting the text in accordance with the basic requirements. Special contributions: Rachin S.A., Prokofieva Yu.S., Parsamyan R.R. – formal analysis writing – review & editing; Rachin A.P., Sharov M.N.– conceptualization, methodology, investigation, data curation, writing – original draft.

Funding. This study was  supported by external sources of funding.

Disclosure. The authors declare apparent or potential conflicts of interest related to the publication of this article. Rachin A.P. – Editor-in-Chief of the Journal “Comorbidity Neurology”, Sharov M.N. – Member of the Editorial Council of the Journal “Comorbidity Neurology”. 

The content is available under the Creative Commons Attribution 4.0 License.

©2025. Rachin A. P., Mikhail N. Sharov, Ruzanna R. Parsamyan et al.