Manual therapy versus mesotherapy in treatment of chronic neck pain

Our experience in the treatment of rotator cuff tears in the ederly patients by a infiltrative and rehabilitative treatment C. Costantino, S. Olvirri, R. Ciraulo, E. Marangio. Physical and Rehabilitation Medicine Postgraduated School , University of Parma, Italy Introduction. Rotator cuff tears are cause of disability in elderly patients. The gold standard treatment is surgery. In selected cases several authors recommended the use of intraarticular infiltration of ialuronic acid in association by a rehabilitative program. The aim of this study is to evaluate the efficacy of rehabilitative and infiltrative treatment with hyaluronic acid in elderly patients with rotator cuff tears, who do not present indications for a surgical intervention or were unwilling to do it. Materials and methods. We have selected 18 patients, (10 men and 8 women), in a range of 70 and 85 years (on average age 77.5 years) with a partial rupture of the rotator cuff showed by ultrasound and / or RMN. All patients showed symptoms like sharp pain, loss of range of motion of the shoulder and loss of autonomy in daily life activities. Each patient has been evalued as far as pain by the Visual Analogic Scale (V.A.S.); and by Constant Murley and Shoulder Rating Questionnaire for functional limitation and independence in daily life activities. We performed a series of three intra-articular infiltration of hyaluronic acid ( molecular weight between 800 and 1200 Kdalton ) followed by a focused.rehabilitation program. Results. The results achieved have been very encouraging since the statistic evaluation showed a great success (p<0,0005) and therefore an improvement of the parameters considered. The protocol we have here shown has been appreciated by all patients who have been satisfied. Conclusion. The infiltrativerehabilitative treatment practiced for these selected cases showed a certain efficacy. The action on pain it’s been possible due to the improvement of the range of motion and the functionality of the shoulder. It may be considered a valid choice instead of a surgical treatment, that is at the moment the gold standard in classic cases of rupture of rotator cuff. However we believe we have to increase our survey . We are planning further follow-up (at 12th month) so as to compare this treatment with others already considered valid in literatur