Revista de Medicina Desportiva (English) March 2018 - Page 23

Most papers indicate that it is a safe technique , however , there are some side effects , such as allergic reactions , bruises , hives , psoriasis induction , panniculitis , prick discomfort , pain during application , due to the pH of some drugs or to the mixture thereof . The administration of a single drug may decrease the likelihood of less drug-drug interaction . 3 , 5 , 11 Although very rare , subcutaneous necrosis and mycobacterial infection are also described , resulting in non-aesthetic scars . 5 The subcutaneous infection , the scars and the subcutaneous nodules are more related to external contamination , bad practice , bad aseptic and incompatibilities of mixtures administered , than with the technique itself . 5 . 8
Mesotherapy has an important role on the rheumatic , traumatic and on sports . It can be applied for the control of pain and inflammation in several pathologies , such as tibiofemoral and patellofemoral , carpometacarpal of the first finger of the acromioclavicular joint osteoarthritis , on the tendinopathy of the shoulder affecting the rotator cuff , on the lateral and medial tendinopathy of the elbow , on the De Quervain tenosynovitis , on the tendinopathy associated to the quadricipital , patellar , Achilles and posterior tibial tendons . It is also used in degenerative degenerative of the cervical and lumbar spine . 6 . 11
On sports trauma , mesotherapy started on the eighties , in France , being used in the tendon , muscular , bone and ligament pathology . 12 On the patellar tendinosis , which often afflicts basketball and volleyball players , the patellar tendon is usually affected on its insertion at the lower pole , triggering pain to palpation . Mesotherapy using a mixture of anesthetic and a NSAIDs with silicon or pentoxifylline will aid to release the pain . 6
In muscular pathology , particularly in the cramp , muscle hernia and muscular rupture , the mesotherapy is not indicated . 6 . 12 It may , however , act as analgesic and relaxing in the acute injuries . When there is a persistent contracture , it is possible to propose a mesotherapy session , in which we associate the procaine with the drug tiocolquicoside , which is very common in cyclist after a great demanding stage . 6 . 12
In the tibial periostitis , a pathology around the bone , it is better to use the manual technique when compared to the assisted technique to avoid the vibration of the pistol over the bone . 12 In this pathology mesotherapy has a great success , using either isolated lidocaine or in association with piroxicam and / or with pentoxifylline . 6
When there is a ligament rupture , for example an ankle sprain , the mesotherapy is useless and one should choose another therapeutic technique . However , if there is no rupture , a combination treatment of physiotherapy and mesotherapy can be prescribed . 12
A study carried out in INSEP ( Institut National Du Sport , of léxpertise et de la performance ) verified that in order to observe an effect with the mesotherapy session , this should not be done on the day of play or on the eve . 12 A weekly intervention was proposed , with no exceptions , and on the first week there could be two sessions spaced by three days . However , in the case of nonimprovement of the symptoms after three sessions , the technique must be abandoned and another alternative therapeutic may be chosen .
11 . 12
Some evidence Cereser et al , in 1985 , in a retrospective study with 133 professional rugby players , verified that the pain associated with post-traumatic injury decreased , resuming physical activity more rapidly in the players submitted to 1-4 sessions of mesotherapy with NSAIDs , muscle relaxants , vasodilators drugs and mepivacaine . 13
In 2009 , Cacchio et al , on a randomized prospective study with 80 participants with calcifying tendonitis in the shoulder , demonstrated the complete disappearance of calcification in 62.5 % of the participants after the application of procaine and EDTA , in three sessions spaced by one week . 3
In 2011 , Narvarte and Rosset- Llobet demonstrated , in a prospective study with 67 participants , with of osteoarticular disturbances , that the use of NSAIDs and of anesthetics medications , performed in three alternating weeks mesotherapy sessions , had pain reduction when compared to the ingestion of naproxen . 3
On my personal experience , as a general practitioner doctor , the muscle skeletal pathology is part of my daily practice . According the records included in the computer system MIM @ UF , about 15 % of the problems that led patients to visit the doctor , at UCSP Anadia I , during the year 2016 , were relate to muscle skeletal pathology , namely back pain , painful shoulder syndrome and osteoarthritis . On the other hand , in my practice of sports medicine , acute muscular injury has a higher incidence when compared to degenerative pathology . We ’ ve using mesotherapy in the tendinopathy of adductor , patellar and Achilles tendons , plantar fasciitis and muscle injuries . In all of these injuries , mesotherapy is playing an important role in fighting pain , reducing the inflammatory process and , consequently , the speed of functional recovery .
Despite the small number of records , at Fiães SC we have noticed
Revista de Medicina Desportiva informa march 2018 · 21
Most papers indicate that it is a safe technique, however, there are some side effects, such as allergic reactions, bruises, hives, psoriasis induction, panniculitis, prick dis- comfort, pain during application, due to the pH of some drugs or to the mixture thereof. The administra- tion of a single drug may decrease the likelihood of less drug-drug interaction. 3, 5,11 Although very rare, subcutaneous necrosis and mycobacterial infection are also described, resulting in non-aesthetic scars. 5 The subcutaneous infection, the scars and the subcutaneous nodules are more related to external contamination, bad practice, bad aseptic and incompatibilities of mix- tures administered, than with the technique itself. 5.8 Mesotherapy has an important role on the rheumatic, traumatic and on sports. It can be applied for the control of pain and inflamma- tion in several pathologies, such as tibiofemoral and patellofemo- ral, carpometacarpal of the first finger of the acromioclavicular joint osteoarthritis, on the tendi- nopathy of the shoulder affecting the rotator cuff, on the lateral and medial tendinopathy of the elbow, on the De Quervain tenosynovitis, on the tendinopathy associated to the quadricipital, patellar, Achilles and posterior tibial tendons. It is also used in degenerative degen- erative of the cervical and lumbar spine. 6.11 On sports trauma, mesotherapy started on the eighties, in France, being used in the tendon, muscular, bone and ligament pathology. 12 On the patellar tendinosis, which often afflicts basketball and volleyball players, the patellar tendon is usu- ally affected on its insertion at the lower pole, triggering pain to palpa- tion. Mesotherapy using a mixture of anesthetic and a NSAIDs with silicon or pentoxifylline will aid to release the pain. 6 In muscular pathology, particularly in the cramp, muscle hernia and muscular rupture, the mesotherapy is not indicated. 6.12 It may, however, act as analgesic and relaxing in the acute injuries. When there is a persistent contracture, it is possible to propose a mesotherapy session, in which we associate the procaine with the drug tiocolquicoside, which is very common in cyclist after a great demanding stage. 6.12 In the tibial periostitis, a pathol- ogy around the bone, it is better to use the manual technique when compared to the assisted technique to avoid the vibration of the pistol over the bone. 12 In this pathology mesotherapy has a great success, using either isolated lidocaine or in association with piroxicam and/or with pentoxifylline. 6 When there is a ligament rup- ture, for example an ankle sprain, the mesotherapy is useless and one should choose another therapeutic technique. However, if there is no rupture, a combination treatment of physiotherapy and mesotherapy can be prescribed. 12 A study carried out in INSEP (Institut National Du Sport, of léxpertise et de la performance) verified that in order to observe an effect with the mesotherapy session, this should not be done on the day of play or on the eve. 12 A weekly intervention was proposed, with no exceptions, and on the first week there could be two sessions spaced by three days. However, in the case of non- improvement of the symptoms after three sessions, the technique must be abandoned and another alterna- tive therapeutic may be chosen. 11.12 Some evidence Cereser et al, in 1985, in a retro- spective study with 133 professional rugby players, verified that the pain associated with post-traumatic injury decreased, resuming physical activity more rapidly in the play- ers submitted to 1-4 sessions of mesotherapy with NSAIDs, muscle relaxants, vasodilators drugs and mepivacaine. 13 In 2009, Cacchio et al, on a rand- omized prospective study with 80 participants with calcifying tendoni- tis in the shoulder, demonstrated the complete disappearance of calcifi- cation in 62.5% of the participants after the application of procaine and EDTA, in three sessions spaced by one week. 3 In 2011, Narvarte and Rosset- Llobet demonstrated, in a prospec- tive study with 67 participants, with of osteoarticular disturbances, that the use of NSAIDs and of anesthet- ics medications, performed in three alternating weeks mesotherapy sessions, had pain reduction when compared to the ingestion of nap- roxen. 3 On my personal experience, as a general practitioner doctor, the mus- cle skeletal pathology is part of my daily practice. According the records included in the computer system MIM@UF, about 15% of the problems that led patients to visit the doctor, at UCSP Anadia I, during the year 2016, were relate to muscle skeletal pathology, namely back pain, painful shoulder syndrome and 7FV'F&ЧF2FRFW"Bג&2ЧF6Rb7'G2VF6R7WFRW2Ц7V"W'2vW"6FV6PvV6&VBFFVvVW&FfPFwv^( fRW6rW6FW&FRFVFFbFGV7F"FV"B6W2FVF2ЧF"f66F2BW66RW&W2bFW6RW&W2W6FW&0r'FB&RfvBЦr&VGV6rFRfF'&6W72B66WVVFǒFR7VV@bgV7F&V6fW'FW7FRFR6V&W"`&V6&G2Bf:6W242vRfRF6V@&Wf7FFRVF6FW7'Fff&&6# +r#