Value of Mesotherapy in Treatment of Fibromyalgia

Document Type : Original Article

Authors

1 Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt

2 Rheumatology Department,, Faculty of Medicine, Beni-Suef University, Egypt

3 Public Health and Community Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt

Abstract

Aim: To evaluate the potential benefit of mesotherapy in the treatment of tender points in fibromyalgia (FM) patients in terms of improving functional ability and quality of life. Methods: The American College of Rheumatology's 2016 criteria were met by sixty Primary FM patients who were enrolled in this study. They were divided randomly into two groups in accordance with the program that was given. Group I: 30 patients received: ketoprofen 150 mg /day for two weeks orally and then on demand + methylprednisolone (MP) 40 mg/weeks for the first 4 weeks intramuscularly, then 40mg/2weeks for another month, `+ esomeprazole 20 mg/day for the study period (two months). Group II: 30 patients received mesotherapy injections in the most painful tender points: 2% lidocaine (1 mL) + ketoprofen 100 mg (2 mL) + MP 40 mg (1 mL) every week for the first month, then every 2 weeks the second month. Patients‟ pain severity, quality of life and depression will be assessed using visual analogue scale (VAS), fibromyalgia impact questionnaire (FIQ) before and after treatment then data were recorded and compared. Results: We found significant improvements (p<0.001) tender points number in the injection mesotherapy group compared to the control group with no significant improvement in VAS and FIQ scales between the two groups. Conclusion: This study supports the idea that injection mesotherapy may represent an effective technique to treat fibromyalgia tender points, especially when there is a high risk of drug interactions, polypharmacy, or when traditional (oral or parenteral) NSAIDs can't be used.

Keywords

Main Subjects


  1. Siracusa R, Paola R.D, Cuzzocrea S, Impellizzeri D.    Fibromyalgia: Pathogenesis,    Mechanisms, Diagnosis and    Treatment Options Update.    Int. J. Mol. Sci. 2021; 22: 3891
  2. Bellato E, Marini E,  Castoldi F,  Barbasetti  N, Mattei  L,  Bonasia DE, Blonna D. Fibromyalgia syndrome: Etiology, pathogenesis, diagnosis, and treatment. Pain Res. Treat. 2012, 2012, 426130. 
  3. Gheita TA, Sayed S, Gheita HA, Kenawy SA: vitamin D status in rheumatoid arthritis patients: relation to clinical manifestation, disease activity, quality of life and fibromyalgia syndrome. Int J Rheun Dis2016;19(3):294-9.
  4. Pistor M. “What is mesotherapy?” Le Chirurgien-Dentiste de France. 1976 ; 46, (288), 59–60.
  5. Mammucari M, Gatti A, Maggiori S, et al. Mesotherapy, definition, rationale and clinical role: A consensus report from the Italian Society of Mesotherapy. European Review for Medical and Pharmacological Sciences 2011; 15:6 (682- 694).
  6. Mammucari M, Vellucci R, Mediati RD, et al. What is mesotherapy? Recommendations from an international consensus.Trends Med 2014; 14:1-10.
  7. Paolucci T, Bellomo RG, Centra MA, et al. Mesotherapy in the treatment of musculoskeletal pain in rehabilitation: the state of the art. J Pain Res. 2019 Jul 30;12:2391-2401
  8. Faetani L, Ghizzoni D, Ammendolia A, Costantino C. Safety and efficacy of mesotherapy in musculoskeletal disorders: A systematic review of randomized controlled trials with meta-analysis. J Rehabil Med. 2021;53(4):jrm00182.
  9. Viscito R, Ferrara PE, Ljoka C, et al. Mesotherapy as a treatment of pain and disability in patients affected by neck pain in spondylartrosis. Ig SanitaPubbl. 2018; 74(1):95–101.
  10. Mammucari M, Gatti A, Maggiori S, Sabato AF. Role of mesotherapy in musculoskeletal pain: opinions from the Italian society of mesotherapy. Evid Based Complement Alternat Med.;2012: Volume 2012, 1-12.
  11. Mammucari M, Maggiori E, Lazzari M, Natoli S. Should the general practitioner consider mesotherapy (intradermal therapy) to manage localized pain? Pain Ther. 2016;5(1):123–126.
  12. Burckhardt CS, Clark SR, Bennett RM.  The fibromyalgia impact questionnaire: development and validation. J Rheumatol . 1991: 18:728–33.
  13. Senara S, Salah H, Abdel Wahed W, Yehia A. Frequency of fibromyalgia syndrome and anxiety post-corona virus disease-2019 (COVID-19) in patients attending the rheumatology clinic. The Egyptian Rheumatologist. 2023; (45), 127–131
  14. Ataog˘lu S, Ankaralı H, Ankaralı S, Ataog˘lu BB, Ölmez SB. Quality of life in fibromyalgia, osteoarthritis and rheumatoid arthritis patients: Comparison of different scales. Egypt Rheumatol 2018;40(3):203–8.
  15. Gheita TA, El Sisi RW, Raafat HA, Khalil HM. Anti-annexin V antibodies in primary fibromyalgia syndrome: relation to associated Sjögren’s syndrome. J ClinImmunol 2013;33(2):311–2.
  16. Plachouri K M, Georgiou S. Mesotherapy: safety profile and management of complications. J Cosmet Dermatol. 2019; 18: 1601-1605.
  17. Paolucci T, Bellomo RG,   Centra M, GiannandreaN,  PezziL,  Saggini R.  Mesotherapy in the treatment of musculoskeletalpain in rehabilitation: The state of the art. J. Pain Res. 2019, 12, 2391–2401.
  18. FaetaniL, Ghizzoni D,  Ammendolia  A,  Costantino C. Safety and efficacy of mesotherapy in musculoskeletal disorders: A systematic review of randomized controlled trials with meta-analysis. J. Rehabil. Med. 2021, 53, jrm00182.
  19. Bárbara S R, Isabel M C. "Mesotherapy in patients with fibromyalgia." RevistaCubana de Reumatología 2012:14.20.
  20. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Häuser W, Katz RL, et al. 2016 revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum 2016; 46: 319– 29.
  21. Eltanawy R, Ganeb S, Fawzy R, Ghorab S: Effectiveness Of Mesotherapy In Treatment Of Fibromyalgia Tender Points.Effectiveness of mesotherapy in treatment of Fibromyalgia tender points. Benha Medical Journal, 2020; Vol. 37, issue 1.
  22. CostantinoC, Marangio E,  Coruzzi G. Mesotherapy versus Systemic Therapy in the Treatment of Acute Low Back Pain: A Randomized Trial. Evid Based Complement Alternat Med. 2011, 2011, 317183.
  23. ViscitoR,  Ferrara PE, Ljoka C, Pascuzzo R,  Maggi L, Ronconi G, Foti C. Mesotherapy as a treatment of pain and disability in patients affected by neck pain in spondylartrosis. Ig. SanitaPubblica. 2018, 74, 95–101.
  24. Ferrara PE, Ronconi G, Viscito R, Pascuzzo R, Rosulescu E, Ljoka C, Maggi L, Ferreiro G, Foti G. Efficacy of mesotherapy using drugs versus normal saline solution in chronic spinal pain: A retrospective study. Int. J. Rehabil. Res. 2017, 40, 171–174.
  25. Sposito MM, Rivera D, Riberto M, Metsavaht L. Mesotherapy improves range of motion in patients with rotator cuff tendinitis.ActaFisiatr. 2011; 18(4): 196 – 199.
  26. Cacchio A, De Blasis P, Desiati G, Spacca V, Santilli F, De Paulis. Effectiveness of treatment of calcific tendinitis of the shoulder by disodium EDTA, Arthritis Care and Research, 2009; (61) 1, 84–91.
  27. Chen L, Li D, Zhong J, Qiu B, Wu X. Therapeutic effectiveness and safety of mesotherapy in patients with osteoarthritis of the knee. Evidence-Based ComplAltern Med. 2018; 4: 6513049.
  28. Saggini R, Di Stefano A, Dodaj I, Scarcello L, Bellomo RG. Pes anserine bursitis in symptomatic osteoarthritis patients: a mesotherapy treatment study. J AlternCompl Med. 2015; 21(8):480–484.
  29. Costantino C, Marangio E, Coruzzi G. Mesotherapy versus systemic therapy in the treatment of acute low back pain: a randomized trial, Evidence-BasedComplementary and Alternative Medicine, 2011, Article, 1-6. Article ID 317183.
  30. Ascher B, Fellmann J, Monheit G. ATX-101(deoxycholic acid injection) for reduction of submental fat. J. Expert Review of Clinical Pharmacology; 2016; 9(9): 1131-1143.
  31. El Kamshoushy A, Abel Maksoud R, El Mahdy N. Evaluation of the Efficacy of Injection Lipolysis using Phosphatidylcholine/DeoxycholateVersus Deoxycholate Alone in Treatment of Localized Fat Deposits. J ClinExpDermatol Res, 2012; 3:146.