Comparison of Mesotherapy Treatment Doses in Patients With Chronic Non-Specific Neck Pain: A Randomised Controlled Double-Blind Clinical Trial

Neck pain is a common health problem in the general population. Approximately 71% of adults experience neck pain at some point in their lives, and its annual prevalence ranges between 30-50% in both the general and working populations. Although neck pain often resolves spontaneously within a few days, it recurs or becomes chronic in about 10% of cases.

Mesotherapy was first described in 1958 by Dr. Michel Pistor as a treatment model based on intradermal injections. It involves administering small amounts of active substances into the superficial layers of the skin using specific injection techniques. Mesotherapy typically includes the application of analgesics, local anesthetics, muscle relaxants, and vasodilators. In addition to cosmetic indications, mesotherapy is also used to reduce pain in musculoskeletal conditions. In 2012, the Italian Society of Mesotherapy published a consensus report outlining the indications, contraindications, and scientific evidence regarding the use of mesotherapy in musculoskeletal pain. However, the exact mechanism of action of mesotherapy remains unclear.

The present study is designed as a prospective, single-blind, randomized controlled clinical trial to evaluate the effectiveness of mesotherapy in patients with neck pain. Before treatment, volunteers will be randomized into four groups by selecting a card. For each session, the following protocols will be applied:

Dry mesotherapy: Needling without injecting any medication.

Normal saline group: Mesotherapy with 3 cc of 0.9% NaCl.

Full-dose medication mixture: Mesotherapy with lidocaine (local anesthetic), meloxicam (analgesic), and 1 cc of 0.9% NaCl.

Half-dose medication mixture: Mesotherapy with half-dose lidocaine, half-dose meloxicam, and 1 cc of 0.9% NaCl.

All volunteers will receive one session per week for a total of three weeks. Improvement is expected in all groups, and the aim of the study is to determine which treatment protocol is the most effective in reducing pain and improving daily functioning.

Demographic data such as age, height, weight, occupation, marital status, and educational level will be recorded. Current medications and comorbid conditions will be assessed. The onset and location of neck pain will be documented. All personal information will be kept strictly confidential and will not be disclosed publicly; even if the study findings are published, the identities of the volunteers will remain anonymous.

Pain will be evaluated using the Visual Analog Scale (VAS) and an algometer. Health-related quality of life will be assessed with the 12-Item Short Form Health Survey (SF-12), and the impact of neck pain on daily activities will be evaluated using the Neck Disability Index (NDI). These assessments will be performed at baseline, one month, and three months after treatment. A total of 88 participants are planned to be included in the study.

Because mesotherapy involves superficial injections with very small amounts of medication, its risk profile is similar to other local injection procedures. The most common adverse effects are bruising, swelling, and mild allergic reactions at the injection site. Depending on the injection technique, pain, skin scratching, reactive cellulitis, and hematoma may occur. These effects are generally mild, uncommon, and self-limiting. When performed by experienced physicians with proper technique and appropriate medical equipment, the risk of complications is low.