Consilium Medicum (Dec 2024)
Treatment patients with musculoskeletal chest wall pain using standard and complex therapy
Abstract
Background. Nonsteroidal anti-inflammatory drugs, muscle relaxants, massage, physiotherapy procedures (standard therapy –ST) are widely used in chronic the chest wall pain syndrom (CWPS). Complex therapy (CT) is more effective with CWPS, including additionally personalized kinesiotherapy, psychological treatment methods and the introduction of anesthetics and corticosteroids into the area of identified sources of pain. There are few studies comparing the effectiveness of standard and complex therapy in CWPS, which was the purpose of our study. Aim. To compare the effectiveness of ST and CT for patients with CWPS. Materials and methods. One hundred four patients with CWPS were observed, of which 52 patients (19 men and 33 women, 49±14.6 y.o.) received ST, 52 patients (20 men and 32 women, 47±15.8 y.o.) received CT. Pain intensity was assessed using a digital rating scale, the presence of mental disorders – according the Hospital Anxiety and Depression Scale (HADS), functional status – according to the Oswestry questionnaire, quality of life – according to the SF-12 questionnaire. Results. After 6 months of therapy, the decreases were observed in the intensity of pain from 6.32±0.48 to 3.53±1.9 points in the ST group and from 6.64±0.75 to 2.67±3.2 points in the CT group (p0.001). A decrease in the severity of depression on the HADS scale from 7.78±0.46 to 6.36±2.6 points in the ST group and from 7.69±3.4 to 5.83±3.4 points in the CT group (p0.001). A decrease in the severity of anxiety on the HADS scale from 10.47±0.63 to 7.63±2.5 points in the ST group from 10.53±0.58 to 6.42±4.2 points in the CT group (p0.001). Reduction of functional disorders on the Oswestry scale from 41.14±0.78 to 22.07±14.2% in the ST group and from 40.91±0.56 to 19.1±17.4% in the CT group (p0.001). Improvement of the quality of life according to the SF-12 questionnaire from 35.01±0.84 to 19.3±21.2 points in the ST group and up to 35.12±0.03 to 13.7±9.8 points in the CT group (p0.001). Conclusion. CT in comparison with ST reduces pain more significantly, improves the functional and emotional state of patients, and improves the quality of life. Widespread introduction of CT CWPS into real clinical practice is recommended.
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