Treating Chronic Pain: New Knowledge, More Choices

Efficacy of Trigger Points Mesotherapy for the Treatment of Chronic Neck Pain: A Short Term Retrospective Study

“…However, it is known that pain can become more complex in its pathophysiology than its original injury. Chronic musculoskeletal pain, like CNP for instance, usually develops as a result of an injury or an insult followed by neurogenic inflammation, hyperalgesia, and allodynia; then occurs a central sensitization followed by a loss of nociceptive control [6,7].…”

“…However, it is known that pain can become more complex in its pathophysiology than its original injury. Chronic musculoskeletal pain, like CNP for instance, usually develops as a result of an injury or an insult followed by neurogenic inflammation, hyperalgesia, and allodynia; then occurs a central sensitization followed by a loss of nociceptive control [6,7].Clinical guidelines for CNP treatment recommends cervical mobilization, thoracic spine thrust manipulation, flexibility exercises for specific muscles group (anterior/medial/posterior scalene, upper trapezius, elevator scapulae, pectoralis minor, and pectoralis major), the use of coordination, strengthening, and endurance exercises to reduce neck pain and headache. To improve recovery in patients with whiplash-associated disorder, clinicians should educate the patient to be more confident in coming back at a well-being status [8].…”

Introductory Chapter: Pain Relief - From Analgesics to Alternative Therapies

“…When a painful injury or pathology is resistant to treatment, when pain persists after the injury or pathology has healed, and when medical science cannot identify the cause of pain, the task faced is much more diicult. The obvious consequence of this is that treatment approaches to chronic pain not only include pharmacologic measures, such as analgesics, tricyclic antidepressants, and anticonvulsants but also interventional procedures, physical therapy, and psychological measures [10,[13][14][15][16]. As a consequence of this, the typical chronic pain management team includes anesthesiologists, occupational therapists, physiotherapists, clinical psychologists, and pain nurses.…”

“…The understanding of the diferent routes involved in this complex phenomenon has opened its therapy not only to drugs, not previously considered as analgesics, but also to the development of pharmaceutical forms able to alleviate pain for long periods of time as well as electrical techniques for the interruption of pain signal transduction [13,14,17].…”

“…In the last decades, the understanding of the multiple mechanisms and molecules that underlie pain perception have turned its treatment into a puzzle formed by therapies that involve not only the common substances considered as analgesics (NSAIDS and opioids) but also a wide array of other drugs such as anticonvulsants and antidepressant and not less important manual techniques, together with psychological follow-up, which has also proved to be successful in containing patients emotionally [10,[12][13][14]. The understanding of the diferent routes involved in this complex phenomenon has opened its therapy not only to drugs, not previously considered as analgesics, but also to the development of pharmaceutical forms able to alleviate pain for long periods of time as well as electrical techniques for the interruption of pain signal transduction [13,14,17].…”