THE BIOCHEMICAL PAIN MEDIATORS AND THE ROLE OF THE THERMAL STAY IN THE GLOBAL APPROACH TO THE PATIENT

INTRODUCTION: patients suffering from skeletal pathology frequently undergo thermal treatments, thank to their efficacy in controlling pain symptoms accompanied with skeletal conditions. Aim of the present investigation has been obtain a better understanding about the possible influences of mud bath therapy, the most frequently used thermal method for the treatment of skeletal pathologies, on several neuropeptides involved in pain transmission. MATERIALS AND METHODS: 48 patients with osteoarthritis (OA) were enrolled in the study and randomized in Group A (12 days mud pack treatment and 500 mg acetaminophen twice a day) and Group B (only drug treatment with 500 mg acetaminophen twice a day). Blood samples were collected for the assay of P substance, CGRP, β-NGF, γ-NP. RESULTS: the statistical analysis has shown a significant difference between baseline and final values in both groups, for all the investigated parameters. The results suggested an efficacy synergy between thermal treatment and pharmacological therapy in group A. DISCUSSION: often in rheumatic patients pain treatment is unsatisfactory and this has led patients and physicians to seek other therapeutic interventions. Mud bath therapy could be taken in account in order to develop a "combined therapy" with the main anti-inflammatory drugs, to decrease dosage and increase the patients' safety. CONCLUSION: in agreement with the data of other authors, it seems that the regular use of mud pack therapy, together with the change of living environment and the spa scene seem to improve the quality of life and to control the main substances involved in neurogenic inflammation.