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