Background/Objectives: Osteoporosis causes a bone mass reduction and often determines acute and chronic pain. Understanding the biochemical and neurophysiological mechanisms behind this pain is crucial for developing new, effective rehabilitative and therapeutic approaches. This systematic review synthesizes recent advances in muscle–bone interactions and molecular pathways related to osteoporosis-associated pain. Methods: We carried out a systematic review including studies published from 2018 to 2024 using PubMed, Scopus, clinicaltrials.gov and Cochrane Library. The Cochrane Collaboration tool was used to assess bias risk. The review adhered to PRISMA guidelines and is registered with PROSPERO (CRD42024574456); Results: Thirteen studies were included. It emerged that osteoporosis causes progressive bone loss due to disruptions in biochemical processes and muscle–bone interactions. This condition is also closely associated with the development of pain, both acute and chronic. Key findings include the role of the miR-92a-3p/PTEN/AKT pathway and the impact of muscle–bone disconnection on bone health. Mechanotransduction is critical for bone maintenance. Effective pain management and rehabilitation strategies include physical therapy and physical exercise, yoga, Pilates, and cognitive behavioral therapy (CBT); they all improve pain relief and functional outcomes by enhancing muscle strength, flexibility, and balance. Pharmacological options such as NSAIDs, opioids, and new agents like SHR-1222, along with surgical interventions like percutaneous vertebroplasty, offer additional pain reduction, especially when included in individualized rehabilitation projects; Conclusions: This review highlights advancements in understanding osteoporotic pain mechanisms and identifies promising treatments. Integrating targeted therapies and rehabilitation strategies can enhance patients’ pain relief.

Background: Hallux valgus (HV) is one of the most common foot deformities and negatively impacts plantar support. The abductor hallucis (AH) is the most important muscle in the etiopathogenesis of hallux valgus, but the effectiveness of its rehabilitation clashes with the difficulty of identifying the most suitable exercises to activate it. Therefore, the aim of this study was to compare four different therapeutic exercises in the activation of AH in these patients. Methods: In this observational case–control study, 48 patients suffering from hallux valgus of moderate/severe grade, according to traditional radiographic classification and the Manchester scale, were divided into two groups: the case group underwent a monthly rehabilitation protocol for their foot deformity, whereas the control group was only evaluated without any intervention. The exercises were as follows: Toe Spread Out (TSO), Short Foot (SF), Forefoot Adduction (FA), and Flexion of the Metatarsophalanges (FM). Both groups were analyzed at baseline and 1 month later (at the end of rehabilitation for the case group) while performing the four mentioned exercises using a surface electromyograph (sEMG) to record the muscle activity of AH in terms of Root Mean Square (RMS) and Maximum Voluntary Contraction (MVC). Results: FA was the only exercise to determine a statistically significant improvement in AH at the end of the rehabilitation cycle, both in terms of RMS (p = 0.015) and in terms of MVC (p < 0.0001), whereas the other exercises did not produce any change in muscle activity in the comparison between times and groups or in the related interaction. Conclusions: FA seems to be the best exercise to activate and train AH, so rehabilitation programs for patients suffering from hallux valgus should consider this exercise as the starting point for improving plantar support, always considering the specific characteristics of HV. Further studies are needed to deepen the effectiveness of this exercise, with the aim of implementing rehabilitation strategies and rethinking traditional HV therapies, which are currently predominantly surgical.

Upper limb dystonia is a focal locomotion disorder affecting arm, forearm, and hand muscles, causing abnormal movements given by repeated, steady, and intercontinuous contractions. There are different types of dystonia and the multifaced nature of this pathology is challenging in the treatment management, leading to a worsening of affected patients’ life quality, mainly from a psychological point of view, but also from a functional perspective. This work examines the present literature regarding upper limb dystonia rehabilitation and treatment with a glance at recent approaches and new treatment strategies. This systematic review was carried out according to the PRISMA statement. The investigation used PubMed, Cochrane, and Google Scholar, including papers from the last ten years. The search yielded 1608 records, all undergone careful screening. A total of 15 papers were selected. The data highlight the importance of combined and customized treatments. The most common strategy included botulinum toxin. Evidence has shown the association between botulinum toxin and therapeutic exercise or occupational therapy. Other approaches involved: tDCS, rTMS and orthosis use, always combined with rehabilitation programs. This pathology requires a multidimensional approach combining personalized therapeutic exercise and other treatments. Nevertheless, further investigations are needed, with a larger population and standardized outcomes to improve dystonia patients’ quality of life and motor abilities.