Extracorporeal Shockwave Therapy vs Mesotherapy in the Treatment of Myofascial Pain Syndrome: a Case-control Study

• Extracorporeal Shockwave Therapy (Group A) (Other): Each patient was evaluated before treatment for trigger points; patients underwent focal ESWT (PulseWave 2 - Mectronic Medicale s.r.l.) with a specific program for muscle contractures and myofascial pain (80-100 mJ with 2250 pulses of 5-10 Hz).
• Mesotherapy (Group B) (Other): Each patient was evaluated before treatment for trigger points; after disinfection with Chlorhexidine 2% and sterile gauze, Thiocolchicoside fl 4mg/2ml, and a local anesthetic, Mepivacaine fl 10mg/1ml, diluted in 0.9% NaCl saline, for a final volume of 10 ml, were inoculated mesodermally; 6 to 12 microinjections with needle 26G 0.40x4mm, were performed.

Primary outcomes

• Extent of pain: Numeric Rating Scale (NRS 0-10) [At the time of recruitment (T0). After 5 weeks from the start of treatment (T1). After 30 days from the end of treatment (T2).]: The NRS is a subjective scale that rates the extent of pain with a score between 0 and 10; a score of 10 corresponds to maximum pain.
• Intensity o f pain: Pressure pain threshold (PPT 1-4) [At the time of recruitment (T0). After 5 weeks from the start of treatment (T1). After 30 days from the end of treatment (T2).]: PPT is defined as the minimum force applied to induce pain in the patient with myofascial pain syndrome. It has a score between 0 and 4; a score of 4 indicates maximum pain.

Secondary outcomes

• Autonomy in activities of daily living: Barthel Index (BI 0-100) [At the time of recruitment (T0). After 5 weeks from the start of treatment (T1). After 30 days from the end of treatment (T2).]: BI is a scale that assesses the patient's autonomy in ADL. A score of 100 corresponds to a normal value.
• Quality of life: Short Form Health Survey 36 (0-100) [At the time of recruitment (T0). After 5 weeks from the start of treatment (T1). After 30 days from the end of treatment (T2).]: SF-36 is a scale that assesses the quality of life in relation to the disease from which patients suffer. A score of 100 corresponds to an optimal value.

Sex: All, ages: 35 Years to 65 Years

Inclusion Criteria:

* Age 35-65 years
* Diagnosis of myofascial syndrome
* NRS at T0 ≥ 4
* Written informed consent

Exclusion Criteria:

* Pregnant patients
* Patients with malignancies already diagnosed or in the process of diagnostic definition
* Coagulation disorders and/or therapy with anticoagulants
* Skin lesions and/or local infections
* Contraindications and/or allergies to the active ingredients of Mesotherapy.

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• Giulia Letizia Mauro, Principal investigator, Functional Recovery and Rehabilitation Unit of the A.O.U.P. Paolo Giaccone