Mesotherapy versus systemic therapy in the treatment of acute low back pain: A randomized trial

Abstract

Pharmacological therapy of back pain with analgesics and anti-inflammatory drugs is frequently associated with adverse effects, particularly in the elderly. Aim of this study was to compare mesotherapic versus conventional systemic administration of nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids in patients with acute low back pain. Eighty-four patients were randomized to receive anti-inflammatory therapy according to the following protocols: (a) mesotherapy group received the 1st and 4th day 2 lidocaine (1mL) + ketoprofen 160mg (1mL) + methylprednisolone 40mg (1mL), then on 7th, 10th, and 13th day, 2 lidocaine (1mL) + ketoprofen 160mg (1mL) + methylprednisolone 20mg (1mL) (b) conventional therapy group received ketoprofen 80mg 2/die and esomeprazole 20mg/die orally for 12 days, methylprednisolone 40mg/die intramuscularly for 4 days, followed by methylprednisolone 20mg/die for 3 days, and thereafter, methylprednisolone 20mg/die at alternate days. Pain intensity and functional disability were assessed at baseline (T0), at the end of treatment (T1), and 6 months thereafter (T2) by using visual analogic scale (VAS) and Roland-Morris disability questionnaire (RMDQ). In both groups, VAS and RMDQ values were significantly reduced at the end of drug treatment and after 6 months, in comparison with baseline. No significant differences were found between the two groups. This suggests that mesotherapy may be a valid alternative to conventional therapy in the treatment of acute low back pain with corticosteroids and NSAIDs.