Physical possibilities in the treatment of chronic abdominal pain in patients with peritoneal adhesions
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Background. The most intensive pains suffered by patients after surgical interventions are caused by post-operative peritoneal adhesions, which are incorrect connective tissue connections formed on or among internal organs and tissues in the abdominal cavity. These adhesion-related pains are resistant to analgesic treatment and often persist for many years. Objectives. In this trial, the estimation of the efficacy of combined treatment with the use of two variable magnetic field related therapeutic methods (magnetotherapy and magnetostimulation) in the treatment of 119 patients with chronic abdominal pains caused by numerous post-operative peritoneal adhesions was performed. Material and methods. 67 patients from the examined group were subjected to two series of 20 daily procedures of exposure to variable magnetic fields in the form of magnetotherapy and magnetostimulation, while 52 patients from the comparison group were subjected to sham exposure, during which no magnetic field was generated in the applicators. Prior to the therapeutic cycle and after its completion, the assessment of pain intensity, with the use of the Visual Analogue Scale (VAS ), and subjective estimation of quality of life, by means of the EuroQol Scale, were performed. Results. In patients from the examined group, a significant decrease in pain intensity, according to the VAS , and a significant improvement of life quality level, on the EuroQol Scale, in comparison to initial values, was achieved (8.0 ± 1.1 vs 2.3 ± 1.0 points, and 30.2 ± 14.1 vs 86.2 ± 8.5 points, respectively (p < 0.05); while in the control group, no statistically significant changes of the estimated parameters were observed. Conclusions. Magnetotherapy and magnetostimulation are efficient therapeutic methods in the case of patients with long-lasting abdominal pain related to peritoneal adhesions, enabling an improvement in their life quality (regardless of gender and age). Taking into account that magnetotherapy and magnetostimulation are not applicable in primary care, family doctors should consider a consultation with a physical therapy specialist in order to prescribe a cycle of physical treatment with the use of these methods in the case of such patients with drug-resistant abdominal pain caused by diagnosed postoperative peritoneal adhesions
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