Management of Tietze syndrome pain with Hilterapia® – a case report

V. Rivetti
Energy For Health [20], 2020

Tietze syndrome is a rare disease of unknown aetiology characterized by painful nonsuppurative swelling over costal cartilages [1]. This condition is differentiated from
costochondritis with the presence of tender swelling at the coastal cartilaginous area. The name of the condition is derived by the doctor who first described it in 1921 [2,3].
The signs and symptoms of Tietze syndrome usually develop before age 40 and the condition affects both sexes equally [4].
The most common affected joints are 2nd and 3rd costochondral junctions and the pain ranges from mild to severe. More than 70% of lesions are unilateral and affect one joint. Multiple lesions affect sameside neighbouring joints. Chest pain is the main complaint, which can be increased by coughing, deep breathing, and lying prone. If left untreated, Tietze syndrome can become chronic, deeply affecting the quality of life of patients. The exact cause of Tietze syndrome is still unknown; however, some researchers have speculated that multiple microtrauma to the anterior chest wall may lead to the development of Tietze's syndrome [5,6].
Treatment strategies are usually conservative and comprise manual therapy and administration of anti-inflammatory agents and analgesics either orally, topically, or by injection. Focal local anaesthetic injection alone may also be a useful therapeutic and diagnostic tool [7].
Physical therapies have also been used to treating the inflammation and pain of Tietze syndrome. In this light, Hilterapia® was considered a new therapeutic approach who can be beneficial for the treatment of patients affected by this pathology.
Hilterapia® peculiarity is its ability to transfer highly energetic photonic packages in deep tissues in a non-invasive way. Studies proved the efficacy of Nd:YAG laser in inducing
photomechanical and photothermal effects in deep structures [8]. The application of Hilterapia® has showed good results in osteoarticular and neuromuscular diseases [9-11] with consequent improvement of patient quality of life [12,13]. This case report describes the application of Hilterapia® in the treatment of a young patient affected by Tietze syndrome that did not respond to pharmacological and physical therapy with the aim of controlling pain and recovering quality of life.