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Drugs injected intradermally spread slowly into the underlying tissues and produce a drug-saving effect. The Italian society of mesotherapy suggested that intradermal therapy obtains analgesic effect on localized pain, with a lower risk of systemic drug interactions. We report a case of post-herpetic pain successfully treated by this technique. This case confirms that the intradermal administration technique (mesotherapy), which is based on the pathophysiology of the disorder, according to the recommendations, can contribute to the management of patients who do not tolerate standard therapies.

Intradermal therapy, known as mesotherapy, is a technique used to inject a drug into the surface layer of the skin. In particular, it involves the use of a short needle to deposit the drug in the dermis. The intradermal microdeposit modulates the drug’s kinetics, slowing absorption and prolonging the local mechanism of action. It is successfully applied in the treatment of some forms of localized pain syndromes and other local clinical conditions. It could be suggested when a systemic drug-sparing effect is useful, when other therapies have failed (or cannot be used), and when it can synergize with other pharmacological or nonpharmacological therapies. Despite the lack of randomized clinical trials in some fields of application, a general consensus is also reached in nonpharmacological mechanism of action, the technique execution modalities, the scientific rationale to apply it in some indications, and the usefulness of the informed consent. The Italian Mesotherapy Society proposes this position paper to apply intradermal therapy based on scientific evidence and no longer on personal bias.

Aims: We report a case of bilateral carpal tunnel syndrome (CTS) in a patient who had been working with repetitive tasks for almost thirty years on his own business as pizza maker in a small restaurant. Food production outside the industry of food processing is often neglected in assessing biomechanical overload as an occupational risk for upper limb musculoskeletal disorders. Presentation of Case: A 54-year old male reported a progressive history of pain and numbness in the thumb and first three fingers of both hands, including dysaesthesia and nocturnal waking. Main factors influencing the risk such as frequency of repetitive movement, strain, posture, pauses, complementary risk factors are described. On site mini-check list Occupational Repetitive Actions (OCRA) assessed 40/50 technical actions per minute with peak acceleration related to customers’ demand and showed a middle-high risk with score 20. Discussion and Conclusion: Criteria used for determining eligibility for compensation are not uniform and according to regulations of a single country may cover different aspects of physiological impairment, work disability, healthcare costs, loss of income and professional retraining. This case highlights the importance of using more easily applicable tools for risk assessment that can be crucial for definition and determination of causation.

Light and heavy manufacturing contribute a great deal to the Italian economy and the products manufactured in this sector form a major part of the exports. Most of the manufacturing industries center around small or medium-sized firms, but there are some larger companies too. Although automation will characterize work in the future, manual labour will remain important for Italian manufacturing products whose quality is recognised worldwide.