Safety and efficacy of mesotherapy in musculoskeletal disorders: A systematic review of randomized controlled trials with meta-analysis.
Lorenzo Faetani, Daniele Ghizzoni, Antonio Ammendolia and 1 others
PMID 33764479WHAT IT FOUND
Mesotherapy injections for musculoskeletal pain reduced pain scores more than systemic medication or placebo in most trials.
Side effects were mild and temporary. However, the treatments varied widely in drugs and techniques, making it hard to know which specific protocol worked best.
Key findings
01Mesotherapy resulted in a statistically significant greater reduction in pain scores compared to control groups across the meta-analysis.
02Adverse events from mesotherapy were generally few, mild, and temporary, with no significant difference from control groups in studies that reported comparisons.
03Functional improvement was significantly better with mesotherapy than controls in two studies treating low back pain and non-specific neck pain.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Extreme heterogeneity in the mesotherapy protocols (different drugs, concentrations, injection techniques, needle sizes, and number of sessions) makes it impossible to recommend a specific standard treatment. The control groups were also heterogeneous, including systemic medication, laser therapy, and ozone therapy, complicating direct comparisons. Several studies did not clearly report adverse events or exclusion criteria, limiting the certainty of the safety profile. The primary outcome was safety, which was not the focus of the meta-analysis effect size; the efficacy findings rely on secondary outcomes. Small sample sizes in several individual trials reduce the robustness of the pooled estimates.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume that all 'mesotherapy' protocols are equivalent. The trials used vastly different combinations of drugs and injection techniques, so a positive result for one protocol does not guarantee the same outcome for another. Additionally, the primary outcome was safety, not efficacy, so the pain reduction findings should be viewed as supportive but not definitive.