Management of sacroiliac joint pain: current concepts DOI Creative Commons
Filippo Migliorini, Ludovico Lucenti,

Tommaso Bardazzi

et al.

European Journal of Orthopaedic Surgery & Traumatology, Journal Year: 2025, Volume and Issue: 35(1)

Published: May 21, 2025

Abstract Introduction Managing sacroiliac joint (SIJ) pain is challenging and unpredictable. There are no internationally accepted recommendations. In light of the lack global consensus guidelines ongoing advancements in management options, a widely treatment algorithm remains absent. This systematic review updates evaluates existing evidence on strategies for managing SIJ pain. Methods study followed defined 2020 PRISMA statement. All clinical studies concerning were considered. Web Science, PubMed, Embase accessed January 2025 without additional filters or temporal constraints. The risk bias evaluation statistical analysis described Cochrane Handbook Systematic Reviews Interventions. Results Fifteen randomised controlled trials, 13 10 retrospective included. Data from 2666 patients (1429 women) retrieved. mean length follow-up was 14.7 ± 15.2 months. age 54.0 5.8 years, BMI 28.5 2.5 kg/m 2 . Non-surgical options primarily focus physical therapy to relieve discomfort. Different medications aim decrease inflammation at SIJ. Fluoroscopically guided injections allow directly administering steroids mesenchymal stem cells into joint. Radiofrequency denervation frequently used address pain, while surgical fusion usually reserved cases where conservative ineffective. Conclusion due limited inconsistent evidence. Treatment progresses physiotherapy, lifestyle changes, non-steroidal anti-inflammatory drugs more invasive approaches like injections, radiofrequency denervation, and, severe cases, management. Research limitations include small sample sizes, short follow-ups, methodologies. Future high-quality needed establish clear diagnostic guidelines, compare techniques, explore new therapies regenerative medicine.

Language: Английский

Hashimoto’s Encephalopathy: Clinical Features, Therapeutic Strategies, and Rehabilitation Approaches DOI Creative Commons
Nicola Manocchio, Valerio Massimo Magro,

Livio Massaro

et al.

Biomedicines, Journal Year: 2025, Volume and Issue: 13(3), P. 726 - 726

Published: March 17, 2025

Hashimoto’s encephalopathy (HE), also known as steroid-responsive associated with autoimmune thyroiditis (SREAT), is an disorder heterogeneous presentation that poses diagnostic challenges. This review synthesizes the current literature to clarify clinical, laboratory, and radiological features of SREAT/HE, including utility thyroid peroxidase (TPO) antibodies, cerebrospinal fluid (CSF) abnormalities, neuroimaging findings. Cognitive impairment behavioral changes are common in HE, but specific manifestations vary widely, which can lead misdiagnosis. While elevated TPO antibodies frequently observed, a direct causal relationship HE unlikely, their presence may indicate general state autoimmunity. Corticosteroids remain cornerstone treatment, although responses vary, alternative immunosuppressive agents or intravenous immunoglobulin be needed some cases. Evidence regarding rehabilitation for people affected by limited, neurorehabilitation strategies adapted from other neurological conditions, cognitive re-education (CR), physical therapy, psychosocial support, beneficial. Further research elucidate underlying mechanisms SREAT, refine criteria, develop more targeted effective therapies, strategies, this debilitating disorder.

Language: Английский

Citations

1
Efficacy and Safety of the Combination of Diclofenac and Thiocolchicoside in the Treatment of Low Back Pain and Other Conditions: Systematic Review of the Literature DOI Open Access

Ioannis Oikonomou,

Karolina Akinosoglou

Healthcare, Journal Year: 2025, Volume and Issue: 13(6), P. 677 - 677

Published: March 20, 2025

Background/Objectives: Low back pain (LBP) is a leading cause of disability worldwide. Diclofenac, non-steroidal anti-inflammatory drug (NSAID), and thiocolchicoside, muscle relaxant, are commonly combined to target inflammation spasm. However, the efficacy safety their combination remain under discussion. This systematic review evaluates diclofenac-thiocolchicoside therapy for LBP other musculoskeletal conditions. Methods: A was conducted following PRISMA guidelines. Eligible studies included randomized controlled trials (RCTs) observational comparing with placebo, monotherapy, or alternative treatments. search performed in PubMed, Scopus, relevant websites, identifying articles published up 30 September 2024. Studies from trial registries were excluded. Risk bias assessed using Revised Cochrane Bias (RoB 2) RCTs Newcastle-Ottawa Scale (NOS) studies. Evidence certainty evaluated Grading Recommendations, Assessment, Development, Evaluations (GRADE) framework. Results visualized Robvis, tables, graphs. Results: Of 393 identified records, 9 (1097 patients) met inclusion criteria. Seven reported significant reduction functional improvement compared placebo active controls. study heterogeneity, dosage variations, risk limited comparability. Adverse events (AEs) gastrointestinal (GI) discomfort drowsiness, though no severe complications consistently reported. Conclusions: Despite methodological limitations, demonstrates promising acute management. there clear evidence its clinical superiority over available treatments, due heterogeneity potential biases. Rigorous, standardized research larger sample sizes consistent methodologies essential definitively establish diclofenac-thiocolchicoside, providing clearer guidance decision-making.

Language: Английский

Citations

0
Rehabilitation for Women and Men Experiencing Sexual Dysfunction After Abdominal or Pelvic Surgery DOI Creative Commons
Nicola Manocchio, Giulia Vita, Laura Giordani

et al.

Surgeries, Journal Year: 2025, Volume and Issue: 6(2), P. 40 - 40

Published: May 14, 2025

Sexual dysfunction following abdominal or pelvic surgery is a significant concern that impacts the quality of life (QoL) for both men and women. This paper explores multifaceted challenges re-educational strategies associated with post-surgical sexual dysfunction. It highlights physical psychological repercussions surgeries such as hysterectomies, organ prolapse repairs, radical prostatectomies, rectal cancer resections. These procedures often lead to complications like dyspareunia, erectile dysfunction, altered body image, necessitating comprehensive approaches. The review emphasizes importance tailored interventions, including floor muscle training (PFMT), biofeedback, manual therapy, advanced techniques botulinum toxin injections sacral neuromodulation. For men, phosphodiesterase type 5 inhibitors (PDE5i), vacuum erection devices (VEDs), intracavernosal injections, penile prostheses are explored their efficacy in restoring function. Psychological support, cognitive–behavioral therapy couples counseling, underscored essential addressing emotional relational aspects recovery. A multidisciplinary approach involving physiatrists, urologists, gynecologists, physiotherapists, psychologists, health counselors advocated optimize outcomes. Integrating modalities, well therapies, into individual rehabilitation projects crucial improving function overall QoL post-surgery. Future research should focus on refining these established investigating potential innovative therapeutic modalities.

Language: Английский

Citations

0
Shoulder Tendinopathy Induced by Statins: A Case Report and Systematic Review DOI Open Access
Nicola Manocchio, Carmelo Pirri, Andrea Sorbino

et al.

Journal of Personalized Medicine, Journal Year: 2025, Volume and Issue: 15(5), P. 198 - 198

Published: May 15, 2025

Background: Statins are essential for managing cholesterol levels but can induce musculoskeletal side effects, including tendinopathy of the shoulder. Rotator Cuff Disease (RCD) is one most common shoulder tendinopathy. The aim present study to report a clinical case statin-induce RCD after performing systematic review on subject. Materials and Methods: We performed literature 49-year-old man with statin-induced treated personalized individual rehabilitation project (IRP) (steroid HA injections, mesotherapy, therapeutic exercise) investigate relationship between statins followed PRISMA guidelines (2020 version), searching PubMed, Web Science, SCOPUS. Results: Out total 217 articles, three cohort studies were suitable our review. Conflicting evidence emerged regarding association from included papers. describes patient who experienced increasing atorvastatin dosage, symptoms improving dose reduction multimodal IRP. Conclusions: may contribute tendon injury by altering extracellular matrix cell membrane integrity. While statin relation still under discussion, clinicians should monitor patients consider switching alternative treatments in arise. demonstrated successful management Further research needed clarify Early diagnosis appropriate crucial optimizing outcomes.

Language: Английский

Citations

0
Management of sacroiliac joint pain: current concepts DOI Creative Commons
Filippo Migliorini, Ludovico Lucenti,

Tommaso Bardazzi

et al.

European Journal of Orthopaedic Surgery & Traumatology, Journal Year: 2025, Volume and Issue: 35(1)

Published: May 21, 2025

Abstract Introduction Managing sacroiliac joint (SIJ) pain is challenging and unpredictable. There are no internationally accepted recommendations. In light of the lack global consensus guidelines ongoing advancements in management options, a widely treatment algorithm remains absent. This systematic review updates evaluates existing evidence on strategies for managing SIJ pain. Methods study followed defined 2020 PRISMA statement. All clinical studies concerning were considered. Web Science, PubMed, Embase accessed January 2025 without additional filters or temporal constraints. The risk bias evaluation statistical analysis described Cochrane Handbook Systematic Reviews Interventions. Results Fifteen randomised controlled trials, 13 10 retrospective included. Data from 2666 patients (1429 women) retrieved. mean length follow-up was 14.7 ± 15.2 months. age 54.0 5.8 years, BMI 28.5 2.5 kg/m 2 . Non-surgical options primarily focus physical therapy to relieve discomfort. Different medications aim decrease inflammation at SIJ. Fluoroscopically guided injections allow directly administering steroids mesenchymal stem cells into joint. Radiofrequency denervation frequently used address pain, while surgical fusion usually reserved cases where conservative ineffective. Conclusion due limited inconsistent evidence. Treatment progresses physiotherapy, lifestyle changes, non-steroidal anti-inflammatory drugs more invasive approaches like injections, radiofrequency denervation, and, severe cases, management. Research limitations include small sample sizes, short follow-ups, methodologies. Future high-quality needed establish clear diagnostic guidelines, compare techniques, explore new therapies regenerative medicine.

Language: Английский

Citations

0