Every patient has their particular views on cellulite. Today it is known that there are about 29 different situations that may cause the orange peel appearance of the skin, which is simply the manifestation of changes that take place in the skin and subcutaneously, and which can be combined into six main groups:
1. Lipoedema:increase in subcutaneous adipose tissue and in free water;
2. Lipo-lymphoedema: increase in subcutaneous adipose tissue and in the quantity of lymphatic liquid;
3. Fibrous cellulite: fibrosclerosis of connective fibres;
4. Lipodystrophy: interstitial and adipose alteration;
5. Localised adiposity: increase in localised adipose tissue;
6. False cellulite: sagging of the skin with fibrosis
According to recent studies, almost all patients with a more or less evident oedema-forming picture experience concomitant painful symptoms. The scope of the research on the direct correlation between the oedema-forming symptoms and symptoms of pain has taken shape particularly in the last few years, and continues gradually to assume an ever greater value in the field of rehabilitation, since both oedema and pain are among the symptoms most frequently encountered and with the greatest impact in the context of chronic pathologies.
The dermis has a countless number of receptors that are capable of perceiving the stimuli of pressure, vibration, 14, touch, heat and pain.
Nociceptors are receptors specialised in the transmission of pain stimuli: the greater the number of nociceptors involved, the greater the sensation of pain will be.
Mechanoreceptors are stimulated by pressing and vibrating inputs. They are receptors that adapt quickly and require continuous and varied stimuli to be activated. Not all of them respond to the same vibration,and there are also differences in their response, according to the frequency of the stimulus.
Those concerned are the corpuscles called Meissner’s, Merkel’s and Pacini’s. Studies conducted at the Faculty of Physical Medicine and Rehabilitation of the G D’Annunzio University of Chieti, and in the Rehabilitation Centre of Montescano (PV), at the IRCCS Foundation “Work Clinic” centre coordinated respectively by Prof. R. Saggini and Prof. R. Casale of the Neurophysiopathology Service, have shown that the Endoroller Therapy method is capable of stimulating the above-mentioned receptors continuously thanks to microvibrations in different ranges, and micropercussions.
The activation of the mechanoreceptors by compressive microvibration thus determines analgesia, thanks to the activation of the Gate Control.
Fig.1 - Gate Control Theory
This theory states that the Spinal Cord sees the convergence of both the fibres of the nociceptors and those of the mechanoreceptors; both are synapses with an interneuron, which is capable of releasing an endogenous opioid, enkephalin. If the fibres of the mechanoreceptors come into contact with the interneuron, this will produce enkephalins, the gate will be closed and transmission of the pain signal will be attenuated; if the fibres of the nociceptors come into contact with the interneuron, this will be inhibited, the gate will open and pain will be felt. (Melzack R., and Wall, P.D., Pain mechanisms: a new theory, Science, 150 (1965) 971-9).
Inflammation represents the most common 16 of algogenicity factors, because the damaged cells release locally chemical substances such as K+, histamine and prostaglandins; platelets release serotonin, while the sensory neurons primary produce peptide P. These chemical
substances sensitise nociceptors by activating them or lowering their activation threshold. Thanks to the draining effect of EndorollerTherapy, there is rapid resorption, by the lymphatic system, of toxic and inflammatory substances, which ensures a fast resolution of inflammation and pain
The analgesic activity of Compressive Microvibration was evaluated through the Breu-Marshall ultrasonic compression test, which shows a clear reduction in the tenderness of cellulite tissues following treatment.
Fig. 2. Breu-Marshall Pain Test.
The test enables us to evaluate how much compression, with the ultrasound probe, is necessary to cause pain. Assessing the differences over time, it is possible to have a significant idea of the result offered by the therapy, which in the case of metabolic improvement must promote a reduction in the pain symptom.