Pelvic pain in Maigne’s syndrome—a multi-segmental approach

Background Maigne’s syndrome is a poorly understood condition that affects the thoracolumbar junction. The symptoms can range from pain in the low back, pelvis, hip, lower abdomen, and groin. These symptoms can have bio-mechanical and neurophysiological attributions due to the complexity of spinal mechanics. Thoraco-lumbar junction (T12-L1) is a transitional zone with a higher degree of mean angular motion and a mean translation motion than T10-T11 and T11-T12. This higher degree of translational and rotation mobility predisposes these segments to a higher degree of stress, making them more prone to biomechanical faults such as dysfunctions and positional faults. These altered static and dynamic mechanics can create a cascade of problems along the biomechanical chain. The co-existence of thoracolumbar junction problems with pelvic pain and dysfunctions strengthens the idea of regional interdependence. Case presentation The patient is a 44-year-old Caucasian male who reported pain in the low back with symptoms radiating to the right hip, iliac region, lower abdomen, and gluteal region. The patient tested positive for Sacroiliac joint dysfunction with both Laslett’s cluster testing and palpatory sacroiliac examination. In addition, the segmental examination showed restriction in thoracolumbar junction with positive skin rolling test and hypomobility in manual segmental testing. Thus, the manual therapy treatment targeted the thoracolumbar junction and sacroiliac joint to address the underlying biomechanical dysfunctions. Conclusions The manual therapy targeting both sacroiliac and thoracolumbar spine can improve pelvic and thoracic spine mobility. In addition, therapeutic exercises can focus on enhancing anterior and posterior chain force generation capacity. This combined approach helped improve functional outcomes with a significant decrease in the Modified Oswestry Disability index and significant improvement on Visual analog scale.

Evaluation of the therapeutic efficacy of original and generic meloxicam in the treatment of acute neck pain

Introduction. In the structure of the global burden of diseases, back pain ranks first in the world in the list of causes of disability. Neck pain is one of the most common diseases of the musculoskeletal system. An integral part of the strategy for the treatment of acute neck pain is the use of original nonsteroidal anti-inflammatory drugs (NSAIDs) with high proven effectiveness.Objective. To conduct a comparative analysis of the therapeutic efficacy of the original drug meloxicam (Movalis) and its generic (Amelotex) in the treatment of patients with acute nonspecific musculoskeletal pain of cervical localization.Materials and methods. The article provides an assessment of the therapeutic effectiveness of the original drug meloxicam (Movalis) and its generic (Amelotex) in the treatment of patients with acute neck pain. Comparative analysis of the results of treatment of 108 patients hospitalized in the Branch of the MC JSC “Admiralteyskie Verfi” aged 18 to 60 years (58 men and 50 women) with a diagnosis of acute dorsalgia of cervical localization (M54.2 according to ICD-10). The average age of patients is 42.5 ± 11.1 years.Results. As a result of the clinical and neurological study and statistical processing of the data obtained, it was found that the use of Movalis in the treatment of patients with acute neck pain was more effective compared to the use of generic (Amelotex). In the Movalis group, the level of pain intensity and the index of disability after treatment was significantly lower than in the Amelotex group at an equivalent dose of 15 mg per day (p < 0.01). The analgesic effect in the group of patients receiving Movalis was longer. There was a significant decrease in sleep disorders associated with pain syndrome in the group (Movalis) compared with patients of the second group (Amelotex). Conclusions. The absence of therapeutic bioequivalence between Movalis and Amelotex revealed in our study determines the relevance of the choice of drugs for the complex therapy of patients of this profile. A multimodal approach to the strategy of treating neck pain, individually patient-oriented, including the use of effective and safe medicines, physical exercises, manual therapy, is optimal.>< 0.01). The analgesic effect in the group of patients receiving Movalis was longer. There was a significant decrease in sleep disorders associated with pain syndrome in the group (Movalis) compared with patients of the second group (Amelotex).Conclusions. The absence of therapeutic bioequivalence between Movalis and Amelotex revealed in our study determines the relevance of the choice of drugs for the complex therapy of patients of this profile. A multimodal approach to the strategy of treating neck pain, individually patient-oriented, including the use of effective and safe medicines, physical exercises, manual therapy, is optimal.

The role of 3D digital applications in Manual Therapy Education – A scoping review

Background: Currently, teaching methods for developing complex physical assessment and palpation skills in manual therapy is challenging for both learners and educators. 3D digital technologies such as virtual reality (VR), augmented reality (AR) and mixed reality may facilitate and/or address these challenges. However, their current usage and/or role in improving learning outcomes in manual therapy education is still largely unknown. Methods: The following electronic databases were searched from Jan 2005 to April 2021: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), Science Direct and Google Scholar. Two independent reviewers reviewed the articles retrieved from the databases to assess for eligibility. Studies of any methodology (quantitative, qualitative and mixed methods) that investigated the use or application of the 3D digital applications were included in the review. Primary outcomes included any outcome related to learning based on the updated Blooms taxonomy. Narrative synthesis was used to synthesise data from the included studies.Results: A total of 4 articles were included in the final review. The main findings were classified into the following key concepts: (1) perception of tissue stiffness, (2) improved student self-efficacy in performing MT techniques, and (3) barriers and facilitators for utilizing 3D technologies. All included outcomes met understanding, applying, analysing and evaluating levels of Blooms taxonomy; however, no outcomes met the ‘creating’ level of Bloom’s taxonomy.Discussion: Our review found that there are no AR, VR or mixed applications that specifically serve the needs of MT education in relation to joint motion assessment, but applications are available that can be readily used or potentially adapted to train skills of tissue palpation. . Therefore, future studies are required to investigate the sophisticated requirements to teach/learn complex manual techniques for which palpation skills may be mandatory.