Chronic muscular skeletal pain syndromes (CMSPS) are one of the major health issues. Despite progress in research, treatment and diagnosis remain difficult. The aim of this study was to examine the influence of somatic dysfunction on CMSPS. A total of 216 patients were examined in a standardized way to assess the influence of morphological and psychosocial factors as well as of somatic dysfunction on CMSPS. Measurements were taken at admission. The results showed a statistically significant link between somatic dysfunction, pain chronicity, pain distribution, and pain-related disability. Since there was no or only a minor correlation between somatic dysfunction and the results of the psychometric testing and the morphological findings, somatic dysfunction should be regarded as an independent factor influencing CMSPS and be further scientifically evaluated.
A violinist with persistent shoulder pain, which had led to his inability to perform for 4 mos, was found to play regularly with extreme external rotation of his violin and left shoulder. Intensive manual and physiotherapy did not cure this problem. A combination of manual and music
medicine focusing on analyzing and changing instrumental movement patterns was able to resolve this pain problem.
Treatment modalities of spinal pain patients are discussed diversely, and different multimodal therapy programs have been developed. Purpose of the present study was to evaluate therapy outcome and effectiveness of an inpatient interdisciplinary and multimodal treatment program.This prospective multicentre clinical trial has been performed with patients from orthopedic hospitals receiving a functional musculoskeletal therapy pathway. Outcome measures were pain intensity and back-specific function (Oswestry Disability Index) before (T1) and after the intervention (T2) as well as after 6 and 12 months (T3, T4). Statistical approach included parametric (t test) and nonparametric (Wilcoxon-test) tests and the calculation of effect sizes. Additionally, a statistical subgroup analysis based on selected parameters (degree of pain chronicity, gender, and age) was performed using linear mixed models.In total, 249 patients (42.6% men, 57.4% women) with spinal pain were included, 133 patients were accessible for follow-up at T3 and 106 patients at T4.Average pain (AP) reduced significantly (P <.001) from T1 to T4 with an effect size of 0.99. Back-specific function also improved (P <.001) over all measuring time points (TP) (effect size: 0.63). Furthermore, the statistical subgroup analysis demonstrated the efficacy of the treatment concept within the subgroup parameters chronicity degree and age.A functional musculoskeletal therapy pathway including treatment of musculoskeletal dysfunctions appears to be beneficial in terms of treating pain and function. Pain chronicity and age seems to be factors influencing therapy outcome. Further studies are needed to examine the superiority of these inpatient programs for back pain including control groups.
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