Mechanical diagnosis and therapy in musculoskeletal pain of individuals with spinal cord injury

J Spinal Cord Med. 2023 Apr 28:1-9. doi: 10.1080/10790268.2023.2197818. Online ahead of print.

Abstract

Context/objective: Musculoskeletal pain (MSKP) has high prevalence in individuals with spinal cord injury (SCI). Mechanical Diagnosis and Therapy (MDT) is a method focused on identifying the pain source in the musculoskeletal system and presents good results in pain relief in people without neurological impairment. However, no studies have investigated the use of MDT in SCI population. The objective was to evaluate the applicability and outcomes of MDT treatment in pain relief and independence improvement in daily activities of individuals with SCI presenting MSKP.

Design: Single-arm trial.

Setting: Rehabilitation Hospital.

Participants: Twenty-four individuals with SCI who presented MSKP.

Intervention: MDT-certified physical therapist conducted assessments and treatments of pain according to the MDT approach.

Outcomes measures: Numeric rating scale (NRS) was used to measure pain and Pain Disability Index (PDI) and Patient-Specific Functional Scale (PSFS) to evaluate daily activities.

Results: Significant median decreases were found for NRS (from 7 to 2) and PDI (from 27 to 8) after MDT, whereas PSFS score presented a significant mean increase (from 3.2-7.7). The average decrease in pain after MDT treatment was 70.9% (5.36 on the NRS).

Conclusion: MDT can reduce pain and enhance independence in daily activities in individuals with SCI and MSKP.

Keywords: Activities of daily living; Exercise; Musculoskeletal pain; Rehabilitation; Spinal cord injuries.