Introduction: Therapeutic ultrasound is a physical modality which is constantly expanding range of indications. Analgesic effect of ultrasound is still under discussion. Regardless the extensive application of pulsed ultrasound of low intensity, continuous ultrasound has a better analgesis effect, which is explained by its mechanism of action. Aims: The main research objective of this study was to determine the effect of continuous ultrasound to pain caused by degenerative diseases of the musculoskeletal system in the intensity and duration of ultrasound treatment. Other objectives are entailed determining the correlation between the degree of pain reduction with: location of pain, age, gender and body mass index (BMI). Material and methods: The study included 68 patients with chronic pain localized in the region of the spine or major joints of the extremities, depending on the localization of the degenerative changes. Patients are divided into two groups. The first group was treated with 10 applications of continuous ultrasound with frequency of 1 MHz, intensity 0.4 W/cm2 for 8 minutes, and the other group with 10 applications of ultrasound with frequency of 1 MHz, intensity 0.8 W/cm 2 for 4 minutes. Results and Discussion: Pain intensity was assessed before and after ultrasound therapy performed by subjective visual analogue scale (VAS) for pain, numbered from 0-10, where 0 is the rating for the state of no pain, and 10 grades for severe pain. The average VAS improvement in the first group was 3.97, and 4.74 in second one. The results of F (1.66) = 2.93, p = 0.09 analysis of variance showed no significance difference between the average improvement of two groups. Correlation between the degree of pain reduction showed significance only with BMI, or that higher BMI is associated with a lower degree of pain reduction. The results of this study showed that application of continuous ultrasound in patients with chronic pain, caused by degenerative changes in the musculoskeletal system, led to a significant reduction in pain. Different intensity and duration of ultrasound application showed no significant effect on the degree of pain reduction. Body mass index showed significant negative correlation with the degree of pain reduction, but age, gender and location of pain did not show significant correlation.

UNLABELLED Prevalence of chronic pain which develops after spinal cord injury (SCI) varies, but in average is 65%. There are many questionnaires and scales for characterisation and classification of chronic SCI pain. One of them is LANSS (Leeds Assesment of Neuropathic Symptoms and Signs) scale for differentiation of neuropathic pain. Aims of this study were: (1) To assess prevalence of chronic pain in the sample of patients with SCl; (2) To classify the pain; (3) To analyse its correlations with demographic and neurological features as well as with activities of daily life (ADL); (4) To evaluate pain treatment. PATIENTS AND METHODS Retrospective, randomized, observational study based on personal interview, Visual Analog Scale (VAS) for pain intensity evaluation, graded from 0 to 10, and on LANSS scale included 100 patients. RESULTS 50% of patients reported existence of chronic pain. In 80% of them pain was below the level of SCI and in 20% of them pain was at the level of SCI. 92% of patients with chronic pain fulfilled LANNS score for neuropathic pain. VAS showed higher intensity of pain among men (average 7.4) than in women (average 6.6). There were positive correlations: between VAS and LANSS scale (p = 0.002), between VAS and age (p = 0.040) and between VAS and level of injury (Pearson rho = 0.329; p = 0.020). 60% of patients declared pain interference with ADL. 24% of patients did not treat pain at all, 16% treated pain with physical procedures and 60% treated pain pharmacologically. CONCLUSIONS RESULTS of this study confirmed high prevalence of chronic pain among patients with SCI, and its features indicated neuropathic type of pain. Pain intensity had positive correlation with gender, age, level of SCI and ADL. RESULTS showed that pharmacological treatment of this pain is much more in use than non-pharmacological one.

Low back pain, with or without propagation to lower extremities, still remains challenge not only for therapy but as diagnostic entity as well. This is the reason why literature is regularly refreshed with new epidemiological studies of low back pain. Six years retrospective study included 55.725 patients rehabilitated in Rehabilitation centre "Reumal" in Fojnica, from January 1997 to December 2002. From this sample it has been isolated 12.296 patients with diagnosis referred to low back pain, in order to get certain epidemiological parameters of low back pain, as: intrahospital prevalence, gender and age overview, overview of diagnostic entities referred to low back pain and their relationship to gender. Total prevalence of low back pain was 22,6 %, ranging from 17,8 % to 28,6 % by years. This epidemiological parameter of low back pain, as well as others, correlate with data of other studies.

The authors presented this case because of the determined characteristics in the clinical picture and electrophysiologic finding which refer to spinocerebral degeneration and neuropathia of the hereditary type, and give the possibility of the classification into two nosologic entities. One is Roussey Levy's syndrome, what is the advisable diagnosis of our patient, and another Freidreich's ataxia. Regardless to the impossibility of the establishing of diagnosis by means the specific enzimatic and genetic tests, the authors on the basis of the clinical picture, electromioncurographic findings and data from the literature of the diagnostic ally decided for Freidreich's ataxya. The neuropathy have classified into the hereditary motor sensor neuropathy--HMSN type II and presented its characteristics.