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Medicina
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Physiotherapy in Musculoskeletal Pain: Assessment and Management
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Physiotherapy in Musculoskeletal Pain: Assessment and Management

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Sports Medicine and Sports Traumatology".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 6471

Special Issue Editors

Dr. Mónica Grande-Alonso

E-Mail Website
Guest Editor
Departamento de Cirugía, Ciencias Médicas y Sociales, Facultad de Medicina, Universidad de Alcalá, Alcala de Henares, Spain
Interests: exercise therapy; rehabilitation; musculoskeletal disorders
Dr. Ferran Cuenca-Martínez

E-Mail Website
Guest Editor
Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
Interests: chronic pain; respiratory disturbances; pain management
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Musculoskeletal pain is a prevalent health issue worldwide, affecting millions of people of all ages. This type of pain, which includes conditions such as arthritis, low back pain and sports injuries, has become a leading cause of disability and absenteeism from work. According to the World Health Organization, it is estimated that up to 20–33% of the global population suffers from some type of musculoskeletal condition, highlighting the magnitude of the problem. Recent studies have indicated that the incidence of these conditions is increasing, especially due to the aging population and the rise in risk factors such as obesity and sedentary lifestyles.

The importance of rehabilitation in the treatment of musculoskeletal pain is undeniable. Rehabilitation not only helps alleviate pain, but also improves patients’ functionality and quality of life. Research has shown that well-designed rehabilitation programs can significantly reduce pain and disability, allowing individuals to resume their daily and work activities. Ongoing research in this field is crucial for developing more effective and accessible methods, optimizing therapeutic outcomes and minimizing the socioeconomic impact of these conditions. Investment in research and the development of new rehabilitation techniques is therefore an urgent need to address the growing burden of musculoskeletal pain globally.

The main objective of this Special Issue of Medicina is to present new advances in the assessment and treatment of various musculoskeletal problems. This Special Issue is open to studies on the evaluation of patients with musculoskeletal disorders, new interventions from a conservative standpoint on musculoskeletal pain, validation of new assessment scales in this population, and systematic reviews and meta-analyses related to the topic.

For this purpose, we recommend that submitted articles cover the following topics:

  • Assessment and treatment of musculoskeletal problems;
  • Application of new technologies for the assessment and treatment of musculoskeletal pain;
  • Application of mental representation techniques, therapeutic education, therapeutic exercise and/or manual therapy for the treatment of musculoskeletal pain;
  • Analysis and conservative treatment of other pathological conditions involving pain.

Authors can submit their studies in the form of clinical outcomes, comparative studies, and systematic reviews and meta-analyses on new advances in the assessment and treatment of these patients.

Dr. Mónica Grande-Alonso
Dr. Ferran Cuenca-Martínez
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • musculoskeletal pain
  • sensorimotor factors
  • therapeutic exercise
  • motor imagery
  • new technologies
  • chronic pain
  • therapeutic education
  • manual therapy
  • rehabilitation
  • functional evaluation

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

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14 pages, 2024 KiB  
Article
Comparative Efficacy of Supervised, Web-Based, and Self-Guided Exercise Interventions in Women with Patellofemoral Pain Syndrome
by Burak Menek and Emre Dansuk
Medicina 2025, 61(4), 731; https://doi.org/10.3390/medicina61040731 - 15 Apr 2025
Viewed by 764
Abstract
Background/Objectives: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition that causes anterior knee pain, often linked to increased joint stress. Rehabilitation typically includes education, strength training, and functional exercises. Recently, telerehabilitation has become a promising alternative, particularly useful in improving access [...] Read more.
Background/Objectives: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition that causes anterior knee pain, often linked to increased joint stress. Rehabilitation typically includes education, strength training, and functional exercises. Recently, telerehabilitation has become a promising alternative, particularly useful in improving access to care in rural areas. This study compares the effects of supervised (SE), web-based (WBE), and self-guided (SGE) exercise programs on pain, functionality, and fear of movement (kinesiophobia) in individuals with PFPS. Materials and Methods: Sixty female patients with PFPS participated in this randomized controlled trial. They were randomly assigned to one of three groups: SE, WBE, or SGE. Each program lasted six weeks, with exercises adjusted based on individual tolerance. Outcomes were assessed using the Kujala Anterior Knee Pain Scale, the visual analog scale (VAS) for pain, the Timed Up and Go Test (TUG) for mobility, and the Tampa Kinesiophobia Scale. Results: All groups showed significant improvements in pain, functionality, and kinesiophobia (p < 0.05). The SE group achieved the greatest improvements across all measures, reducing pain and kinesiophobia while enhancing functionality (p < 0.017). The WBE group also showed significant improvements, outperforming the SGE group in all outcomes (p < 0.017). The SGE group demonstrated the least improvement but still achieved positive changes. Conclusions: Supervised exercise programs were the most effective in managing PFPS symptoms. However, the web-based programs also provided substantial benefits, making them a viable option when in-person supervision is not feasible. Future research should aim to enhance digital interventions for broader accessibility and engagement. Trial Registration: The study protocol was also registered on ClinicalTrials.gov (NCT06625086). Full article
(This article belongs to the Special Issue Physiotherapy in Musculoskeletal Pain: Assessment and Management)
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12 pages, 335 KiB  
Article
Current State of Dry Needling Practices: A Comprehensive Analysis on Use, Training, and Safety
by Juan Antonio Valera-Calero, Gustavo Plaza-Manzano, Gabriel Rabanal-Rodríguez, María José Díaz-Arribas, Mateusz D. Kobylarz, Jorge Buffet-García, César Fernández-de-las-Peñas and Marcos José Navarro-Santana
Medicina 2024, 60(11), 1869; https://doi.org/10.3390/medicina60111869 - 14 Nov 2024
Cited by 1 | Viewed by 3294
Abstract
Background and Objectives: Dry needling (DN) is a technique that involves inserting a thin filament needle through the skin to target myofascial trigger points for the treatment of musculoskeletal pain and dysfunction. Despite its efficacy in a broad plethora of musculoskeletal pain [...] Read more.
Background and Objectives: Dry needling (DN) is a technique that involves inserting a thin filament needle through the skin to target myofascial trigger points for the treatment of musculoskeletal pain and dysfunction. Despite its efficacy in a broad plethora of musculoskeletal pain conditions, its safety remains a topic of debate among clinicians and researchers. The aim of this study was to provide an overview of the current practice of DN through a national survey, focusing on the frequency of its use and the incidence of adverse events (AEs), considering factors including physiotherapist experience, clinical workload, the extent of training received by practitioners, and the use of ultrasound guidance. Materials and Methods: An online cross-sectional survey was conducted. Respondents were licensed physical therapists (PTs) working in Spain. The survey covered demographics, professional data, frequency of adverse effects, and if they use ultrasound routinary for guiding interventions. Results: A total of 422 PTs participated in the study, mostly having 21–60 h of DN training (38.6%), less than 2 years of experience (36%), and not using ultrasound during the interventions (85.5%). Post-needling soreness and bent needles were the most common AEs, with most severe events rarely reported. Adverse event frequencies varied significantly based on training hours, experience, patient percentage treated with DN, and weekly clinical dedication. Clinicians with more hours of DN training or fewer years of experience reported higher incidences of certain complications. Conclusions: DN is a common intervention among PTs, with minor AEs frequently occurring and major AEs being less common but still significant. The accidental puncture of non-desired structures highlights the necessity for improve training on anatomical landmarks, needle insertion depth, cross-sectional anatomy education, and patient monitoring. To ensure safe practice, emphasize comprehensive training, adhere to safety protocols, exercise caution, and prioritize the use of ultrasound-guide is encouraged. Full article
(This article belongs to the Special Issue Physiotherapy in Musculoskeletal Pain: Assessment and Management)

Review

Jump to: Research, Other

12 pages, 294 KiB  
Review
Corticosteroid Use in Musculoskeletal and Neuraxial Interventions: Effects on Glycemic Control
by Brian Singer, Dovid Chaimovitz, Thomas Bucek, Eli Dayon, Aimee Abbott-Korumi, Moshe Spatz, Tejaswi Makkapati, Hayk Petrosyan and Laurent Delavaux
Medicina 2025, 61(5), 936; https://doi.org/10.3390/medicina61050936 - 21 May 2025
Viewed by 450
Abstract
Effective multidisciplinary pain management involves an in-depth knowledge not only of diagnosis and treatment but of how interventional procedures affect patients across all health domains. One of the most common pharmacological tools utilized in patients suffering from chronic pain disorders is corticosteroids. Corticosteroids [...] Read more.
Effective multidisciplinary pain management involves an in-depth knowledge not only of diagnosis and treatment but of how interventional procedures affect patients across all health domains. One of the most common pharmacological tools utilized in patients suffering from chronic pain disorders is corticosteroids. Corticosteroids are leveraged for their anti-inflammatory properties across a wide range of disorders. This review examines the role of corticosteroids and pain management with a specific focus on their metabolic impact regarding glucose metabolism. Corticosteroids have been shown to increase gluconeogenesis, resulting in reduced insulin sensitivity and an impaired peripheral glucose uptake. These varied responses to corticosteroids are especially concerning given the high prevalence of diabetes mellitus in chronic pain patients. There is well-documented evidence of not only transient hyperglycemia but emerging literature on prolonged glycemic disturbances that may have a greater effect on patients than previously recognized. A review of the available literature reveals variations in hyperglycemia depending on corticosteroid type, dose, and various patient-specific factors. Some research does suggest that lower corticosteroid dosages can provide similar therapeutic benefits and potentially reduce glycemic aberrations. Given the current evidence, clinicians should closely monitor patients’ hemoglobin A1C levels when determining the risks and benefits of an interventional procedure and consider alternative pain management strategies when appropriate. Future research should focus on optimizing corticosteroid selection and dosing to balance the safety, particularly in diabetic or prediabetic patient populations. Full article
(This article belongs to the Special Issue Physiotherapy in Musculoskeletal Pain: Assessment and Management)

Other

Jump to: Research, Review

30 pages, 1302 KiB  
Systematic Review
Understanding Exercise-Induced Hypoalgesia: An Umbrella Review of Scientific Evidence and Qualitative Content Analysis
by Mario González-Iglesias, Alexis Martínez-Benito, Javier Andrés López-Vidal, Alberto Melis-Romeu, Daniel Jacobo Gómez-Rabadán, Álvaro Reina-Varona, Silvia Di-Bonaventura, Roy La Touche and José Fierro-Marrero
Medicina 2025, 61(3), 401; https://doi.org/10.3390/medicina61030401 - 25 Feb 2025
Viewed by 1293
Abstract
Background and Objectives: Exercise-induced hypoalgesia (EIH) is a topic of interest in the scientific community. This umbrella review aimed to analyze EIH research and compare it with public dissemination on X. Materials and Methods: We selected relevant EIH reviews that included [...] Read more.
Background and Objectives: Exercise-induced hypoalgesia (EIH) is a topic of interest in the scientific community. This umbrella review aimed to analyze EIH research and compare it with public dissemination on X. Materials and Methods: We selected relevant EIH reviews that included a healthy population or patients with pain and studied exercise interventions. A systematic literature search was carried out in PubMed, Web of Science, SciELO, PEDro, and Google Scholar, employing the Population, Intervention, Comparison, and Outcome strategy. Data were extracted and summarized, and methodological quality was assessed with the Quality Assessment Scale for Systematic Reviews, and risk of bias with the Risk of Bias in Systematic Reviews tool. The Physical Activity Guidelines Advisor Committee was employed for evidence synthesis. Simultaneously, advanced X website searches gathered EIH-related content for analysis. Information from posts on X was qualitatively analyzed and contrasted with evidence in the literature. Results: We included nine systematic reviews and 17 narrative reviews. Systematic reviews presented high methodological quality. However, half had low risk of bias, while the other half presented high risk of bias. The EIH in healthy participants was controversial for some exercise modalities, such as aerobic exercise, and the influence of psychological variables. Modalities, such as isotonic resistance exercise, showed favorable effects on hypoalgesia. However, in patients with musculoskeletal pain, different exercise modalities did not generate EIH. X analysis unveiled a considerable representation of science-related content, although with prevalent misinterpretations of scientific evidence. Conclusions: EIH has been extensively studied, yet the certainty of evidence remains limited. While some exercise modalities demonstrate hypoalgesic effects in asymptomatic individuals, these effects remain unverified in patients with musculoskeletal pain. Moreover, the analysis of social media content highlights frequent misinterpretations of scientific evidence, particularly conflating hypoalgesia with analgesia. This underscores the need for more precise, evidence-based communication on social media platforms. Full article
(This article belongs to the Special Issue Physiotherapy in Musculoskeletal Pain: Assessment and Management)
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