AB0915 Эффективность акупунктуры при терапевтических упражнениях при лечении миофасциальной боли в нижней части спины
Authors: Evgenia Guryanova, Oleg Tichoplav
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Myofascial pain syndrome in the lower back is one of the most common diseases. At the current time, there are no ideal ways to treat this disease. Pharmacological treatments are not suitable for many patients. Regular use of painkillers and NSAIDs is associated with the risk of serious adverse reactions in patients. Using only pharmacotherapy without using non-pharmacological treatment methods is not a rational approach to treating such patients. Acupuncture has a wide range of effective methods of combating combat syndrome that can have a quick positive effect, and, unlike drugs, this method remains safe. Therapeutic exercise is a treatment method that is able to raise the general threshold of pain sensitivity by including non-specific adaptation mechanisms [1]. This effect develops slowly, but it acts for a very long time. <h3>Objectives</h3> The purpose of this study is to compare the effectiveness of acupuncture with massage in the treatment of myofascial pain in the lower back with complex treatment, including exercise. <h3>Methods</h3> A prospective clinical study was conducted with patients suffering from myofascial pain syndrome in the lower back, which were randomly divided into one of two groups: patients (60 cases) who received combined treatment including massage, acupuncture and exercise therapy, and patients (30 cases) of group 2 (G2) who received only massage procedures and acupuncture without medical gymnastics. They were assigned to group 1 (G1). The age composition of the G1 group of patients from 31 to 70 years. Gender composition - 22 (37%) - women, and 38 (63%) - men. All patients received treatment 5 times a week (from Monday to Friday, excluding Saturday and Sunday), the total duration of the rehabilitation course is 10 days. The therapeutic program included the following non-drug methods of exposure: for G1, 30 minutes - an acupuncture session, 20 minutes a back massage session, and at least 45 minutes of exercises in the gymnastics hall with an instructor in physical therapy. G2 patients received similar non-drug therapy with the exception of classes in the gymnastics room. The visual-analogue scale (VAS) was used as a method of performance evaluation, which was evaluated at the beginning of the study, at the fifth, ninth and last visit to the clinic. <h3>Results</h3> The average time between the onset of clinical symptoms and the first day of treatment was 34.6 days. In 80% of patients, a history of pain lasted for more than 3 months. 89 patients (98%) completed the protocol: 60 (100%) in G1 and 29 (97%) in G2. The average VAS score in G1 was 6.9 at the beginning of the study and after the tenth session it dropped to 2, 6. A significant decrease in pain was registered in the G2 group (from 6.9 at the beginning of the study to 3.3 after the tenth session). A statistically significant difference (p &lt;0. 05) between different sessions was noted. In order to assess the period of time during which the effect of treatment is maintained, all patients were asked to send a subjective assessment on the VAS scale to the attending physician after completion of treatment monthly for 12 months. When analyzing these data, it was established that the inclusion of physiotherapy exercises preserves a clear effect of therapy for 3.1 months longer than without the use of therapeutic gymnastics. <h3>Conclusion</h3> The results indicate high efficiency acupuncture in the treatment of myofascial pain syndrome, however, its combination with therapeutic exercises allows to better consolidate the effect and contributes to a longer remission of pain syndrome. It is necessary to establish clear criteria for inclusion in the treatment of exercise <h3>Reference</h3> [1] Krysyuk O.B., Lutkov V.F., Smirnov G.I., Shadrin D.I. Physiotherapy and massage in the complex rehabilitation of athlete. Ministry of Sport of the Russian Federation, PF Lesgaft National State University of Physical Education, Sport and Health, St. Petersburg. St. Petersburg, 2014. <h3>Disclosure of Interests</h3> None declared