A Comparative Study of Therapeutic Efficacy of Double – Modality Therapy, Phonophoresis and Cryotherapy in the Management of Musculoskeletal Injuries in Jos

Abstract

Musculoskeletal injuries ( MSIs ) account for approximately 25% of patients‟ complaints in the primary health care settings and are a leading cause of work absenteeism world-wide. Physical treatments like phonophoresis ( PH ) and cryotherapy ( CRYO ) are being used to reduce pain, control swelling and improve function. The recognition of the importance of pain control in the recovery from MSIs has prompted clinicians to continue to explore more aggressive pain management strategies. It is suggested that PH and CRYO could be combined ( double-modality therapy – DMT ) in managing MSIs for better outcome. There is dearth of information in the literature to support the practise or demonstrate its ( DMT ) efficacy or superiority over the single treatment protocol. This work was a prospective study therefore, designed to investigate the therapeutic efficacy of DMT in the management of pain among participants who suffered from MSIs. Participants were assigned randomly to one of three groups: DMT group ( n=20 ) received cryotherapy and 15% methyl salicylate phonophoresis, PHONO group ( n=20 ) received 15% methyl salicylate phonophoresis and CRYO group ( n=20 ) received cryotherapy and „sham‟ phonophoresis. Pre-and post-treatment pain perception scores ( PPS ) among the participants using visual analogue scale ( VAS ) and the duration of treatment in all groups were recorded. Treatment was administered on alternate days in all groups. The result shows a total of 275 treatment sessions was recorded in the three groups - 72 ( 26.2% ) in DMT, 105 ( 38.2% ) in PHONO and 98 ( 35.6% ) in CRYO group which indicates no significant difference ( p > 0.05 ) in treatment sessions in favour of DMT. The difference in the severity of pain before and after treatment was remarkable and statistically significant ( p < 0.05 ) in each group which suggests that DMT, phonophoresis and cryotherapy were equally effective. DMT protocol was significantly ( P < 0.05 ) effective in its group, but could not significantly produce more pain relief among the participants when compared with the two other groups. In conclusion, the current study has indicated the significant therapeutic efficacy of DMT, but it could not produce more pain relief than the two other protocols ( PHONO and CRYO ). However, the result has indicated that it might take less or fewer sessions to treat and make the participants included in this study pain free and fit to return to active performance when DMT is considered.