[Study of the relationship between adherence to back school and coping with pain in patients with chronic low back pain]. / Estudio de la relación entre adherencia a la Escuela de la Espalda y afrontamiento del dolor en pacientes con lumbalgia crónica.

INTRODUCTION: Back School (BS) is a treatment modality for patients with chronic low back pain with educational contents associated with other therapeutic measures such as exercise. If followed, it is effective but it is well known that it is difficult to make changes to daily habits. This study evaluated whether patients completing BS had a predominance of active strategies in coping with pain, as they adhered better to the recommendations of BS. MATERIAL AND METHOD: Prospective observational study to evaluate BS adherence in patients with chronic low back pain. Adult patients attending BS were included in the study. Patients whose educational level, concomitant pathology or personal situation prevented them from completing the study were excluded. The patients were evaluated at the beginning and after the third session of BS. The variables studied were adherence to exercises and recommendations, coping with pain, pain intensity, functional disability and other sociodemographic characteristics. RESULTS: A total of 67.2% of the 116 included patients acknowledged that they did not perform the exercises and recommendations of BS every day. No relationship was established between patients with active strategies for coping with pain and adherence to BS. Functional capacity and pain intensity did not differ between adherent and non-adherent patients. CONCLUSIONS: This study did not demonstrate that adherence to the exercises and habits taught in BS is related to coping with pain strategies, pain intensity and functional capacity in patients with chronic low back pain.

Mesoterapia como opción terapéutica en patología dolorosa del aparato locomotor / Mesotherapy as a therapeutic option in painful condition of locomotor apparatus

Introducción. La mesoterapia es una técnica que consiste en la aplicación de múltiples inyecciones intradérmicas (dermis profunda) con diferentes fármacos según las patologías a tratar. Es utilizada en distintas especialidades médicas, siendo especialmente interesante su uso en dolor, síntoma prevalente en nuestra especialidad. Introducción. El objetivo de este trabajo es valorar la eficacia y seguridad de este tratamiento en pacientes con patología dolorosa crónica del aparato locomotor. Material y métodos. Realizamos un estudio prospectivo de los resultados obtenidos con la aplicación de esta técnica en 59 pacientes, derivados a la consulta de Rehabilitación y afectos de distintas patologías. Los fármacos utilizados para el tratamiento del dolor fueron una combinación de Piroxicam, Lidocaína al 1% y Pentoxifilina. Para evaluar resultados utilizamos al inicio y final del proceso la Escala Visual Analógica (EVA), el Cuestionario de salud EuroQol-5D (EQ-5D tarifa) y la medición del diámetro de la zona dolorosa. El análisis estadístico se realizó con el programa informático SPSS V15.0 y el método consistió en una comparación de medias utilizando una t de student para datos emparejados de cada uno de las tres instrumentos de medida utilizados. Resultados y conclusiones. Ningún paciente abandonó el tratamiento. Edad media: 46 años. El 74,5% de pacientes fueron mujeres. La cervicalgia fue la patología más frecuentemente tratada. Demostramos una mejoría estadísticamente significativa (p<0,001) de la patología dolorosa del aparato locomotor tras el tratamiento con mesoterapia, con unos descensos medios de 52,28mm (IC 95%: 44,78–59,79) en la EVA y de 45,86cm (IC 95%: 30,97–60,75) en el diámetro de la lesión y un aumento medio en el EQ-5D tarifa de 0,3550 (IC 95%: 0,2924–0,4177). Como únicos efectos secundarios, un 26% de pacientes presentaron hematomas en la zona de aplicación que se resolvieron espontáneamente. Resultados y conclusiones. La mesoterapia es un método de tratamiento eficaz y seguro para el tratamiento de la patología dolorosa crónica del aparato locomotor(AU)

Introduction. Mesotherapy is a technique that consists in the application of multiple intradermal injections (deep dermis) with different drugs according to the conditions to be treated. It is used in different medical specialties, its use being especially interesting in pain, a prevalent symptom in our specialty. Introduction. This work has aimed to assess the effectiveness and safety of this treatment in patients with chronic painful condition of the locomotor apparatus. Material and methods. We conducted a prospective study of the results obtained with the application of this technique in 59 patients, referred from the Rehabilitation Service, suffering from different conditions. The medications used for pain treatment were a combination of Piroxicam, Lidocaine 1% and Pentoxifylline. The Visual Analogue Scale (VAS), the Health Questionnaire EuroQol-5D (EQ-5D Index score) and the measurement of the painful zone diameter were used to evaluate the results. The statistical analysis was conducted with the SPSS V15.0 computer program and the method consisted in a comparison of means, using the Student's T test for matched data of each of the 3 measurement instruments used. Results and conclusions. None of the patients dropped out of the treatment. Their mean age was 46 years old and 74.5% of the patients were women. Neck pain was the most frequently treated condition. We have demonstrated a statistically significant improvement (p<0.001) of the painful condition of the locomotor apparatus after mesotherapy treatment, with mean decreases of 52.28mm (95% CI: 44.78–59.79) in the VAS, 45.86cm (95% CI: 30.97–60.75) in the lesion diameter and average increase in the EQ-5D Index score of 0.3550 (95% CI: 0.2924–0.4177). As side effects, 26% of the patients had hematomas in the application zone that resolved spontaneously. Results and conclusions. Mesotherapy is a safe and effective method for the treatment of chronic painful condition of the locomotor apparatus(AU)

Claudicación intermitente como manifestación del síndrome de Pratesi / Intermittent claudication as a clinical expression of Pratesi's syndrome

El síndrome de Pratesi se caracteriza por la existencia de múltiples fístulas arteriovenosas en los miembros inferiores y por afectar preferentemente al varón durante la edad media de la vida. Clínicamente, cursa con claudicación intermitente bilateral en la pantorrilla, no progresiva, con períodos de remisión espontánea, asociada a frialdad subjetiva en los pies, con aumento real de la temperatura. No aparece dolor en reposo y no se asocia a trastornos tróficos.Presentamos el caso de un varón de 36 años con dolor en el gemelo interno del miembro inferior derecho, desde hacía años, que le impedía realizar esfuerzos continuos. La confirmación diagnóstica se realizó mediante estudio angiográfico, tratándose de manera conservadora. La presencia de múltiples comunicaciones arteriovenosas dificulta el tratamiento quirúrgico, resultando imposible ligarlas todas.El objetivo principal de la presentación de este caso clínico es describir las características clínicas de este síndrome y aportar un nuevo caso a los pocos referidos en la literatura médica revisada (AU)

The syndrome of Pratesi is characterised by the existence of multiple arteriovenous fistulas in lower members, which affect mainly men in their middle age. Clinically evolves with non progressive bilateral intermittent claudication in calf, with periods of spontaneous remission, associated to a subjective coldness in feet together with a real increase of temperature. No pain appears when at rest, and trophic disorders are not associated.AbstractWe present the case of a man of thirty-six with a pain in the inner gemellus of his right lower member. It has prevented him from making a continued effort for years. Diagnosis should be confirmed by means of angiographic study and the treatment was conservative. The present of multiples communication arteriovenous is difficult for the chirurgical treatment because it is impossible to joint them all. The main objective of this clinical case presentation is to describe the clinical characteristics of this syndrome and also provide a new case to the few reported in the literature reviewed (AU)