Neck Pain in Fibromyalgia: Treatment with Exercise and Mesotherapy

Background and Objectives: Fibromyalgia is a very common musculoskeletal disease. The purpose of this study is to assess, on a population of fibromyalgic patients, the clinical efficacy of antalgic mesotherapy with diclofenac and thiocolchicoside in the treatment of cervical pain reduction for improvement of the functional capacity and quality of life of these patients. Materials and Methods: We conducted an observational study of 78 fibromyalgia patients recruited using our hospital database. Based on the different types of treatment received, the patients were divided into two groups: the treatment group (TG), who received antalgic mesotherapy with diclofenac, thiococolchicoside, and mepivacaina; and the placebo group (PG), who received mesotherapy with sodium chloride solution. Patients in both groups also received the same rehabilitation protocol of 20 sessions. The primary outcome evaluated was the extent of pain. The secondary outcomes were the functional capacity and quality of life. Results: Pain improved both in the treatment group (7.4 ± 1.2 vs. 5.1 ± 1.1; p < 0.05) and placebo group (7.5 ± 1.4 vs. 6.1 ± 1.6; p < 0.05). The treatment group, compared to the placebo group, also showed significant statistical improvements in functional capacity (NDI: 35.6 ± 5.23 vs. 19.3 ± 3.41; p < 0.05) and quality of life (SF-12: 18.3 ± 4.11 vs. 33.1 ± 2.41; p < 0.05). Conclusions: Mesotherapy treatment with diclofenac and thiocolchicoside is a safe and effective procedure in the management of neck pain in fibromyalgia patients in the short term in terms of pain reduction, functional recovery and quality of life

Aderenza alla terapia farmacologica con bisfosfonati: nostra esperienza

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An intense physical rehabilitation program determines pain relief and improves the global quality of life in patients with fibromyalgia

OBJECTIVES:It is accepted that the optimal management of patients with fibromyalgia (FM) requires a combination of non-pharmacological and pharmacological interventions. Our study aimed to analyse the effects of a supplemented physical program on the quality of life of FM patients.METHODS:We enrolled 60 patients, all female (mean age 49±5.7 years), with primary FM (mean years of disease 33±12 months). Patients who agreed to participate in this study met the proposed 1990 American College of Rheumatology classification criteria and the 2010 American College of Rheumatology preliminary diagnostic criteria and were recruited at Policlinico P. Giaccone, University Hospital of Palermo, Italy. Thirty patients undertook a physical program consisting by group exercises, laser and TENS treatment (Combi-group). The remaining 30 FM patients (Exonly-group) practiced only group exercise (Control group). Ten patients with mechanical pain were considered as unrelated control group disease. Fatigue, sleep dysfunction and pain were reported and evaluated before and after the treatment for each patient. Particularly, the Fibromyalgia Impact Questionnaire (FIQ), SF36 Questionnaire (SF36) and Visual analogic scale for pain and fatigue (VAS pain and fatigue) were administered at baseline (T0) and at the end of the treatment (T1) (after 40 rehabilitation sessions over 20-week).RESULTS:The combined treatment significantly improved the perception of pain and fatigue and the overall quality of life. In detail, the Combi-group experienced a statistically significant improvement in FIQ but not in the SF36 after the treatment. CONCLUSIONS:According to our results, an intense physical rehabilitation program could be considered a promising essential step in the management of FM patients

Trattamento riabilitativo dopo acromion-plastica ed impianto di spaziatore sub-acromiale per lesione della cuffia dei rotatori

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IL TRATTAMENTO RIABILITATIVO NELLA MALATTIA DI OLLIER: CASE REPORT

La malattia di Ollier è una displasia condromatosa congenita caratterizzata dalla presenza di encondromi multipli con deformità ossee associate. Nel nostro studio presentiamo il caso clinico di un pz D.S.D. di sesso maschile di 59 anni affetta da malattia di Ollier giunto presso il nostro ambulatorio nel dicembre 2013 lamentando poliartralgie con prevalente interessamento delle anche e delle ginocchia. associate a limitazione funzionale e difficoltà nella deambulazione da diversi anni.Il pazinete è stato sottoposto au progetto-programma riabilitativo individuale consistente in TENS, rieuducazione funzionale e propriocettiva degli arti inferiori e trainig deambulatorio eseguito a cadenza quotidiana per un totale di 3o sedute. Al termine del trattamento riabilitativo è stata evidenziata una riduzione della sintomatologia algica ed un buon incremento della funzione articolare e della forza muscolare con migliori perfomance del paziente nello svolgimento delle ADL

La sindrome dello stretto toracico superiore: case report

La nostra esperienza conferma la validità della terapia fisica, della rieducazione funzionale distrettuale e degli esercizi respiratori nella TOS, associati al trattamento farmacologico con neurotrofici. Il nostro protocollo riabilitativo ha consentito un ripristino delle ADL, una migliiore tolleranza allo sforzo e di conseguenza una migliore qualità di vita

Effetti della terapia con Laser Nd- Yag nel trattamento riabilitativo della lombosciatalgia acuta: nostra esperienza

Per lombosciatalgia si intende un a sindrome radicolare caratterizzata da dolore lombare e defcit neurologico segmentale secondaria a compressione dell radici spinali L4- L5-S1-S2. Lo scopo di questo lavoro è stato quello di valutare l'efficacia del Laser Nd Yag nel trattamento della lombosciatalgia acuta in pazienti allergici a FANS in termini temporali e quantitativi. L'utilizzo del laser Nd Yag ha permesso una migliore aderenza all'esercizio terapeutico potenziandone l'efficacia espressiva in termini di riduzione del dolore e della contrattura antalgica dei muscoli paravertebrali e conseguentemente nel migliorare la qualità della vita

IS THERE A RELATIONSHIP BETWEEN MILD-MODERATE BACK PAIN AND FRAGILITY FRACTURES? ORIGINAL INVESTIGATION

Introduction: Fragility fractures are the cause of 43 thousand deaths: 50% are caused by femur fractures, 28% by vertebral fractures and 22% by various fractures in women, in men the percentages are 47%, 39% and 14% respectively. Vertebral fractures are the most common, 30-50% women over age 50 will experience one of them. Worldwide, is estimated that a new vertebral fracture occurs every 22 seconds. Additionally, vertebral fractures strongly predict the risk of both further fractures and re-fractures, in any skeletal segment. Vertebral fractures are often asymptomatic. Early diagnosis of these is extremely important. The aim of the study is to show, within a population of women over-50 in post-menopause, the correlation between mild-moderate back pain and fragility fractures, pain intensity and number of fractures to decide an early diagnostic path reducing new fractures risk. Materials and method: This observational study was conducted between January 2016 and January 2018 with a total examination of 4000 physiatric outpatient, 615 were over 50 years old woman with back pain for at least 3 months not responding to conservative treatment and with NRS between 2 and 4; 513 patients have been enrolled in this study. All patients are physiatric outpatient at the U.O.C. of Rehabilitation of University Hospital “P. Giaccone” of Palermo. We include Post-menopausal women over 50, having intermittent back pain for for at least 3 months, not responding to conservative treatment, with NRS between 2 and 4 and SF 36 between 60 and 100. We do not include patient with rheumatological pathologies, recent traumas, bone metastasis, osteomyelitis and previous vertebral fracture. All patients underwent a instrumental examination was also conducted with a dorsal-lombar X-Ray (L/L), in standing position. The semi-quantitative morphometric Genant method was used for the diagnosis of the vertebral fractures. Result: Data analysis showed that 41% (213/513) have vertebral fractures at dorsal-lombar X- Ray in L/L projection, using the semi-quantitative morphometric Genant method. 685 vertebral fractures have been shown with an average of 3.2 per patient: 74,59% are dorsal vertebral fractures and 24.1% are lombar. 77.5 % (165) of patients referred an NRS rate between 2 and 3 (first group) and 22.5% (48) a rate of 4 (second group). 66.1% of patients belonging to the first group showed more than 3 fractures and 33.9% from 1 to 2 vertebral fractures. 89.6% of patients belonging to second group has more than 3 fracture, 10.4% from 1 to 2 vertebral fractures. The Fischer test showed a P-value <0,001 regarding correlation between NRS and number of vertebral fragility fractures. Conclusion: As we underline in the introduction, vertebral fractures are usually asymptomatic and, consequently undiagnosed. This observational study demonstrate that mild-moderate back pain, in post menopause woman resistant to conservative therapy and still with a good quality of life, is a significant symptom for an early diagnosis of vertebral fragility fractures. © 2020 A. CARBONE Editore. All rights reserved

An intense physical rehabilitation programme determines pain relief and improves the global quality of life in patients with fibromyalgia

It is accepted that the optimal management of patients with fibromyalgia (FM) requires a combination of non-pharmacological and pharmacological interventions. Our study aimed to analyse the effects of a supplemented physical programme on the quality of life of FM patients