Effect of Neural Therapy on shoulder dysfunction and pain in supraspinatus tendinopathy

Objectives: To investigate the effect of 1% procaine injection, which is used in neural therapy, on shoulder pain and dysfunction in patients diagnosed with supraspinatus tendinopathy. Methods: The Range of Motion values, Visual Analog Scale and the QuickDASH Scale scores of 70 patients, who were diagnosed with musculus supraspinatus tendinitis based on magnetic resonance imaging findings, were analyzed. The data of the scales obtained before neural therapy and at the follow-up visit at four weeks after the end of therapy were compared, and a p-value of <0.05 was considered statistically significant. Results: After neural therapy, a statistically significant increase was observed in Range of Motion values and there was a statistically significant decrease in both the Visual Analog Scale and QuickDASH score averages. Conclusion: This is one of the rare studies showing the effects of neural therapy application on shoulder pain severity and dysfunction in patients with supraspinatus tendinitis who are resistant to medical therapy. doi: https://doi.org/10.12669/pjms.38.3.4823 How to cite this:Bashan I, Ozturk GY. Effect of Neural Therapy on shoulder dysfunction and pain in supraspinatus tendinopathy. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4823 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

A Systematic Review of Complementary and Alternative Veterinary Medicine: “Miscellaneous Therapies”

There is an increasing interest in complementary and alternative veterinary medicine (CAVM). There is, however, an uncertainty of the efficacy of these methods. Therefore, the aim of this systematic literature review is to assess the evidence for clinical efficacy of 24 CAVM therapies used in cats, dogs, and horses. A bibliographic search, restricted to studies in cats, dogs, and horses, was performed on Web of Science Core Collection, CABI, and PubMed. Relevant articles were assessed for scientific quality, and information was extracted on study characteristics, species, type of treatment, indication, and treatment effects. Of 982 unique publications screened, 42 were eligible for inclusion, representing nine different CAVM therapies, which were aromatherapy, gold therapy, homeopathy, leeches (hirudotherapy), mesotherapy, mud, neural therapy, sound (music) therapy, and vibration therapy. For 15 predefined therapies, no study was identified. The risk of bias was assessed as high in 17 studies, moderate to high in 10, moderate in 10, low to moderate in four, and low in one study. In those studies where the risk of bias was low to moderate, there was considerable heterogeneity in reported treatment effects. Therefore, the scientific evidence is not strong enough to define the clinical efficacy of the 24 CAVM therapies.

Neuropathy Case Seen After Bariatric Surgery

Peroneal neuropathy is a rare complication after bariatric surgery, but it occurs in 15% of mononeuropathy. The etiology of peroneal neuropathy is multifactorial and is often blamed for these factors due to rapid weight loss and nutritional imbalance. Emine Karaca, 25 years old, female Patient 1 year ago, she had a stomach reduction (obesity surgery) surgery due to her weight of 130 kg. Six months after the operation, it decreased to 60 kg. Meanwhile, numbness in his right foot began to be pain and loss of strength after the operation. In the EMG performed on May 10, 2016, he was diagnosed with Fibulahead entrapment neuropathy-low foot. He was tied to lie in the same position for a long time during the operation. After this diagnosis, 15% prolotherapy was applied around the peroneal nerve of the fibular head on 11.05.2016. Prolotherapy was applied 2 times with 10 days intervals. L4-5 and L5-S1 segmental neural therapy in the lumbar region and neural therapy around the fibular head of the peroneal nerve and along its trace were applied twice a week. After a total of 2 prolotherapy and 6 neuraltherapy applied in 3 weeks, complete clinical recovery was achieved. This complete recovery was confirmed by EMG. Since electrophysiological findings of denervation occur after 2-3 weeks, it is recommended that EMG examination be performed 3 weeks later. Treatment includes relief of complaints (analgesics and gabapentin), physical therapy applications and support immobilizers. In cases that do not respond to treatment, nerve exploration and relaxation is provided with a surgical approach. Prolotherapy and neural therapy, among complementary medicine modalities, can also be used in peroneal nerve neuropathy.

Effects of local anesthetics (neural therapy) on pain and hand functions in patients with De Quervain tenosynovitis: A prospective randomized controlled study

Objective: De Quervain tenosynovitis is the most common cause of lateral wrist pain. The diagnosis can be made with the Finkelstein test when pain is provoked with wrist ulnar deviation. Conservative treatment including rest, non-steroidal anti-inflammatory medication and physical therapy is applied first, then there may be a need for corticosteroid injections, and in resistant cases, surgery. The aim of this study was to evaluate the effectiveness of neural therapy (NT) on pain and hand functions in patients with De Quervain tenosynovitis. Methods: A total of 36 patients admitted between May 2019 and March 2020 were randomly assigned to neural therapy (NT) and control groups. Hand rest and thumb spica splint were applied to all the patients, and NT interventions to the NT group only. A visual analog scale (VAS) and the Duruöz Hand index (DHI) were used to measure pain and functionality at baseline, then at 1 and 12 months after the end of the treatment. Results: The NT and control groups both showed improvements in VAS and DHI scores at 1 and 12 months compared to baseline. The VAS scores were significantly lower at both 1 and 12 months compared to baseline in the NT group. The DHI scores were lower in the NT group at 1 month, and at 12 months there was no significant difference between the two groups. No adverse effects were seen in any patient. Conclusion: NT seems to be effective in reducing pain and improving hand functions in patients with De Quervain tenosynovitis.

Treatment of Localized Vulvar Pain with Neural Therapy: A Case Series and Literature Review

<b><i>Background:</i></b> Localized vulvar pain (LVP) is a common condition among fertile women, with physical and psychosexual implications. Treatment is complex with limited benefits. Neural therapy is a regulatory therapy that uses injections of local anesthetics in low concentrations in specific points to treat different conditions. <b><i>Case Presentation:</i></b> We present the cases of 5 women, ages 33–44 years, with LVP treated with procaine 0.5% injections in painful points. Complete relief from pain occurred in 2 patients, and significant improvement in 3. Only 1 or 2 sessions were required. Initial VAS score was ≥70 and decreased to ≤30 after the intervention. The improvement was maintained over time, with a minimum follow-up period of 6 months. None of the patients were able to have sex or use tampons due to pain, but they were able to resume after the intervention. <b><i>Conclusions:</i></b> In this case series, local injections of procaine showed a favorable outcome. Future randomized clinical trials could help elucidate the role of this intervention in LVP.