ORIGINAL ARTICLE   Free access

European Journal of Physical and Rehabilitation Medicine 2019 August;55(4):472-9

DOI: 10.23736/S1973-9087.19.05432-7

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Efficacy of intradermal administration of diclofenac for the treatment of nonspecific chronic low back pain: results from a retrospective observational study

Gianpaolo RONCONI ¹ ✉, Giorgio FERRIERO ², Cristina NIGITO ¹, Calogero FOTI ³, Giulio MACCAURO ⁴, Paola E. FERRARA ¹

¹ Unit of Physical Medicine and Rehabilitation, Teaching Hospital Foundation “Agostino Gemelli”, IRCCS, Rome, Italy; ² Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy; ³ Department of Physical Medicine and Rehabilitation, Clinical Sciences and Translational Medicine, Tor Vergata University, Rome, Italy; ⁴ Orthopedic and Traumatology Institute, Catholic University of the Sacred Heart, Rome, Italy

BACKGROUND: Intradermal administration of analgesic drugs with mesotherapy is effective for the local treatment of musculoskeletal pain. Few studies analyzed the effects of different drugs administrated with this technique.
AIM: The aim of this study was to compare the efficacy of diclofenac versus lysine acetylsalicylate-based mesotherapy in relieving pain (primary outcome), and disability (secondary outcome) in patients with nonspecific chronic low back pain.
DESIGN: Retrospective observational study.
SETTING: Outpatient rehabilitation medicine center.
POPULATION: Records of 101 patients with nonspecific chronic low back pain.
METHODS: Data were extracted from the outpatients records of patients affected by nonspecific chronic low back pain since 12 weeks before, treated with 5 sessions of mesotherapy with diclofenac mixtures (group A) or aspirin-lysine acetylsalicylate mixture (group B). Assessments recorded were taken before the first treatment (T0), at the end of the 5-week treatment (T1), and at 4 (T2) and 12 weeks (T3) of follow-up after the last treatment, using a pain visual analogue scale (VAS) primary outcome, Oswestry Disability Index (ODI) secondary outcome, and the Short-Form McGill Pain Questionnaire (SF-MPQ) Comparisons within and between groups were performed using the t-test, the χ2 test, and analysis of variance (ANOVA) models, as appropriate.
RESULTS: Records from 101 patients consecutively were analyzed, 51 in group A (mean age and standard deviation [SD]=62.8±10.7; F/M=33/18) and 50 in group B (mean age±SD=64.1±15.8; F/M=30/20). At baseline VAS, SF-MPQ, ODI scores were respectively 7.6±1.3, 22.49±9.96, 44.80±15.55 (mean and SD) in group A; VAS, SF-MPQ, ODI scores were respectively 6.7±1.6, 18.66±9.65, 39.04±16.06 (mean and SD) in group B. Mean differences between group A and group B in the changes of scores from baseline (T0) to end of study (T3) were -1.3 (VAS), -5.81 (SF-MPQ) and -17.05 (ODI). Mesotherapy induced significant reductions in pain severity and disability in both groups with better results in diclofenac-based treatment.
CONCLUSIONS: This retrospective pilot study suggests the efficacy and safety of diclofenac mesotherapy for relieving pain and disability in patients affected by chronic nonspecific low back pain in a convenient sample but further studies will confirm these results.
CLINICAL REHABILITATION IMPACT: Diclofenac mesotherapy appears to be a viable treatment. to reduce pain and improve function in patients affected by chronic moderate-to-severe nonspecific low back pain.

KEY WORDS: Rehabilitation; Spine; Injections, intradermal; Mesotherapy