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青少年肌肉骨骼疼痛管理热疗法专家意见

Expert opinion on heat therapy for teenagers' musculoskeletal pain management.

作者信息

Rodriguez-Maruri Guillermo, Celotto Stefano, Guidi Damiano, Hirschmüller Anja, Sosa González Guillermo

机构信息

Primary Care Musculoskeletal Unit, Area V, Health Service of the Principality of Asturias (Servicio de Salud del Principado de Asturias, SESPA), Gijón, Spain.

Primary Care Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.

出版信息

Ann Transl Med. 2024 Oct 20;12(5):84. doi: 10.21037/atm-23-1931. Epub 2024 Aug 5.

Abstract

BACKGROUND

Among children and adolescents, up to 40% will experience musculoskeletal pain (MP), which can significantly impair functional ability, reduce quality of life, cause emotional distress, and lead to sleeping disorders for both patients and their families. The first-line treatment often involves pharmacological interventions, even though there is a lack of evidence supporting the efficacy or the safety of this approach in this specific age group. Recent guidelines recommend the implementation of preventative strategies and physical tools as the first option to minimize the use of medications. We aimed to provide an expert opinion on the use of heat therapy for MP management in young patients.

METHODS

This paper is the result of a virtual advisory board held by the authors in order to discuss and provide an expert opinion about the use of heat therapy in MP in children and adolescents.

RESULTS

MP is a significant burden affecting children and adolescents. While non-steroidal anti-inflammatory drugs are currently the first-choice treatment of acute and chronic MP in children and adolescents, avoiding or reducing them in such patients is advisable, to reduce side effects and to prevent the development of chronic pain and medication overuse headaches. Heat therapy can be an additional treatment option due to its ability to promote muscle relaxation, enhance blood circulation, and modulate nociceptors with a good safety profile.

CONCLUSIONS

MP in children and adolescents is a common condition that should be approached multidisciplinary, including information, therapeutic exercise and physical therapies like hot or cold therapies. Future studies should be conducted to evaluate the safety, efficacy and indications of each treatment in MP.

摘要

背景

在儿童和青少年中,高达40%的人会经历肌肉骨骼疼痛(MP),这会显著损害功能能力、降低生活质量、导致情绪困扰,并给患者及其家人带来睡眠障碍。一线治疗通常涉及药物干预,尽管缺乏证据支持这种方法在该特定年龄组中的疗效或安全性。最近的指南建议实施预防策略和物理手段作为首选,以尽量减少药物的使用。我们旨在就热疗法在年轻患者MP管理中的应用提供专家意见。

方法

本文是作者召开的虚拟咨询委员会的结果,目的是讨论并提供关于热疗法在儿童和青少年MP治疗中应用的专家意见。

结果

MP是影响儿童和青少年的一个重大负担。虽然非甾体抗炎药目前是儿童和青少年急性和慢性MP的首选治疗方法,但建议在此类患者中避免或减少使用,以减少副作用并防止慢性疼痛和药物过度使用性头痛的发生。热疗法因其能够促进肌肉放松、增强血液循环并调节伤害感受器且安全性良好,可作为一种额外的治疗选择。

结论

儿童和青少年的MP是一种常见病症,应采用多学科方法进行处理,包括提供信息、进行治疗性锻炼以及采用热疗或冷疗等物理疗法。未来应开展研究以评估每种治疗方法在MP中的安全性、疗效和适应症。

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