Management of musculosketal pain

Musculoskeletal pain has an important impact on quality of people’s lives. Chronic pain causes several complications, such as: disturbed and fragmented sleep, fatigue, depression, and inability to participate in some daily activities.

The World Health Organization (WHO) defines musculoskeletal disorders as “health problems of the musculoskeletal system, namely muscles, tendons, bone skeleton, cartilages, ligaments and nerves. This includes all types of ailments, from small transient discomfort to irreversible and disabling injuries. ”

Among the diseases that manifest musculoskeletal problems, the fibromyalgic syndrome, or fibromyalgia, is the most disabling one.

Fibromyalgia

Fibromyalgia is a chronic rheumatic disease that is characterized by widespread muscle pain in the absence of inflammation signs, and often in association with other symptoms such as fatigue, sleep disorders, memory deficits and concentration issues.

The pain associated with fibromyalgia is generally chronic and persistent, predominantly in the muscle-tendon system, which involves more regions of the body, as neck, shoulder and arms.

Therapeutic strategies

Currently there is no cure for fibromyalgia; it is therefore important to intervene in a multidisciplinary manner to limit the painful symptomatology of those suffering from it.

In other hands, it is well known that the management of musculoskeletal disorders includes both non-pharmacological treatments (physiotherapy, manual therapy, etc.) and pharmacological treatments (NSAIDs, analgesics, etc.).

Manual therapy is a method of treatment used by physiotherapists and physiatrists, who use highly specialized manual techniques to solve patients’ neuro-musculoskeletal dysfunctions. The objectives of manual therapy are to reduce pain and inflammation, improve joint mobility and reduce muscle tension. Exercise is also useful in this category of subjects, especially when it is alternated between light aerobic exercise (walking, cycling) and postural exercises or mild muscle strengthening, to help strengthen the musculoskeletal structures.

An important aid for the management of muscle stiffness and tenderness is given by Cetylated Fatty Acids (CFAs) patented by Pharmanutra S.p.A. in Cetilar® brand products. CFAs are a mix of fatty acids of plant origin that have proven to be effective in reducing muscle-joint and tendon pain.

Cetilar® products consist of 3 products for topical use (Cream, Patch and Tape) and an oral food supplement (Cetilar® Oro). The latter, containing a new ingredient called Lipocet®, is the result of 8 years of research by PharmaNutra Spa. In fact, in February 2022, the European Union approved the marketing authorization of Lipocet® as Novel Food.

Cetilar®Cream

Cetilar® Cream assists massage by helping the ability to articulate and move in joint diseases on an osteoarthritic basis. The massage thus reduces the painful symptomatology at the joint and musculoskeletal level, being useful even in case of sports trauma. The cream can be applied up to 2 times a day on the affected area.

Cetilar® Patch

Cetilar® Patch helps to restore mobility and function of the joints, as well as relieve pain in the event of trauma, stretching, contractures and sprains. A recent study published in the international journal BMC Musculoskeletal Disorders involved subjects with shoulder tendinopathy. The results showed how the application of the Cetilar®Patch for 10 consecutive days was useful in reducing pain and increasing joint function in subjects suffering from this frequent clinical condition.

Cetilar® Tape

This product is an inelastic adhesive tape, designed to reduce pain symptoms in case of muscle and joint disorders, such as sports trauma, sprains, tension, and contractures. Its formula with Cetylated Fatty Acids allows effective and targeted absorption directly in the sore anatomical area.

Cetilar® Patch and Cetilar®Tape features:

• adhere easily to the skin;
• resist to sweat and water;
• ensure proper absorption through the skin tissue;
• allow the recovery of joint mobility and functionality;
• have a pleasant and refreshing scent.

Cetilar®Oro

Cetilar® Oro is the newer and only food supplement based on CFAs, thanks to the experience of topical Cetilar® products. Recently, a study has also been published showing that 4-weeks treatment with Lipocet® has been shown to be effective in reducing pain and improving mobility in individuals with chronic back pain.

CFAs mechanism of action

The mechanism of action of CFAs is to promote joint lubrication and therefore to improve mechanically the movement of the joint. In addition, it has been shown that the beneficial effect produced by CFAs, applied by therapeutic massage in subjects with osteoarthritis pain syndrome, could be mediated by the mechanical modification of the synovial membrane, thereby reducing painful symptoms.

In conclusion, the products branded Cetilar®, thanks to the action of Cetylated Fatty Acids, are useful in improving joint mobility and reducing painful symptoms in the joints, muscles,skeleton and tendons. It can be a valuable aid in pain management in some clinical conditions, such as fibromyalgia, or musculoskeletal disorders.

Bibliography:

• https://www.who.int/
• Babatunde OO, Jordan JL, Van der Windt DA, Hill JC, Foster NE, Protheroe J (2017) Effective treatment options for musculoskeletal pain in primary care: a systematic overview of current evidence. PLoS ONE 12(6): e0178621.
• Crawford, C. Boyd, C. F. Paat, K. Meissner C Lentino, L. Teo, K. Berry e P. Deuster. Dietary ingredients as an alternative approach to mitigating chronic musculoskeletal pain: evidence-based recommendations for practice and research in the army. Medicine of pain, 20 (6), 2019, 1236-1247
• https://www.pharmanutra.it/en/brand/pharmanutra/
• https://www.humanitas.it/malattie/fibromialgia/
• Pelak A, Barve A, Carroll K, Madrazo-Ibarra A, Vad V (2023) Effect of Cetylated Fatty Acid Supplementation on Axial Discogenic Low Back Pain. Int J Phys Med Rehabil.11:662
• Lanzisera R, Baroni A, Lenti G, Geri E. A prospective observational study on the beneficial effects and tolerability of a cetylated fatty acids (CFA) complex in a patch formulation for shoulder tendon disorders. BMC Musculoskelet Disord. 2022 Apr 12;23(1):352. doi: 10.1186/s12891-022-05304-x. PMID: 35413878; PMCID: PMC9003972.