mobic and Low-Back-Pain

To compare extracorporeal shock wave therapy combined with oral medication and an exercise program vs sham treatment with medication and exercise for the treatment of chronic low back pain (CLBP).. Randomized controlled trial.. Outpatient clinic at a university hospital.. Eligibility criteria were age older than 18 years and duration of CLBP exceeding 3 months. Exclusion criteria were concurrent treatment or history of surgery for CLBP, cancer, fractures, infections, and disk degeneration.. The intervention group received extracorporeal shock wave therapy once a week for 4 weeks along with oral medications and an exercise program. The control group received sham extracorporeal shock wave therapy along with oral medications and an exercise program.. Visual analog scale and Oswestry Disability Index (ODI) were used to assess pain and disability at baseline and after 3 months.. The pain score in the intervention group (N=16) was 6.6 at baseline and 3.0 after 1 month (P<.0001) and 1.8 after 3 months (P<.0001). In the control group (N=16), the pain score was 6.8 at baseline, 4.6 after 1 month (P<.0001), and 1.1 after 3 months (P<.0001). ODI scores decreased significantly in both groups compared with baseline values (first month: P<.001, third month: P<.05). The mean ODI score did not differ significantly between the groups (P=.942).. Extracorporeal shock wave therapy combined with oral medication and exercise was safe and effective in the short-term treatment of chronic low back pain.

Topics: Adult; Analgesics; Anti-Inflammatory Agents, Non-Steroidal; Clonidine; Combined Modality Therapy; Disability Evaluation; Exercise Therapy; Extracorporeal Shockwave Therapy; Female; Humans; Low Back Pain; Male; Meloxicam; Middle Aged; Pain Measurement

Low back pain (LBP) is a common and costly illness. This randomized, double-blind, placebo-controlled, cross-over study tested the hypothesis that periradicular injections of meloxicam would reduce LBP and improve physical activity compared to a saline injection at 3 months follow-up.. After IRB approval, 80 consenting patients suffering LBP of <6 months duration were randomly assigned to the control (C-group, N.=40, receiving 10 mL of saline) or the meloxicam (M-group, N.=40, receiving 10 mg in 10 mL saline). If the pain Numeric Rating Score (NRS) at 24 hours remained >50% of the pretreatment score, the patient was crossed-over to the other group. A successful treatment was NRS<3 at 3 months follow-up. Secondary outcome measures which were assessed included work-absence, physical-assistance, physical-activities limitations and pain-related insomnia.. The baseline NRS was 9.3 (95% CI: 8.9-9.7) in the C-group and 9.2 (95% CI: 8.8-9.6) in the M-group. At the 24 hours follow-up after the initial treatment, the mean NRS was 6.3 (95% CI: 5.4-7.2) in the C-group vs. 3.5 (95% CI: 2.6-4.4) in the M-group (P<0.05). The number of cross-over cases was significantly higher in the C-group (N.=31, 77.5% vs. N.=5, 12.5%, P<0.001). At the 3 months follow-up, 66 patients (35+31) were allocated in the M-group and 54 (82%) reported NRS Score <3, while only 14 (9+5) patients remained in the C-group and eight patients had NRS<3.. Periradicular injection of meloxicam is an effective analgesic treatment for acute/subacute LBP. This novel use of meloxicam also leads to an improvement in the level of physical activity at the 3-month follow-up.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Cross-Over Studies; Double-Blind Method; Exercise; Female; Follow-Up Studies; Humans; Injections; Low Back Pain; Male; Meloxicam; Middle Aged; Prospective Studies; Spinal Nerve Roots; Time Factors

Efficacy and safety of movalis (meloxicam) injected into trigger points of 94 patients with vertebrogenic lumbago-ischialgia syndrome have been assessed. Patients have been stratified into 3 randomized groups: the first group received 3 injections of movalis into trigger points with the following administration of tablets (15 mg per day); 2nd group received - 3 intramuscular injection movalis with the following administration of tablets (15 mg per day); 3nd - was control. Treatment efficacy has been assessed with the Visual-Analogous scale, a five-point scale for assessment of vertebroneurological symptoms, the Oswestry Disability Index, the McGill Pain Questionnaire, stimulating ENMG. Patients treated with movalis injections into trigger points and intramuscular had no local side-effects. The analgesic effect was more pronounced after three injections into trigger points compared to the intramuscular injection. The efficacy of treatment was the highest in the first group (75,6%) comparing to the 2nd (64,3%) and the 3rd (33,3%) ones.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Humans; Injections, Intramuscular; Low Back Pain; Meloxicam; Thiazines; Thiazoles; Treatment Outcome

The main aim of the study was a search for factors influencing efficacy of movalis used in combined form, injection and tablets, for the treatment of patients with acute back pain syndrome (BPS) and evaluation of the drug safety. Thirty patients, 18 female, 12 male, mean age 43.1 years, with primary BPS have been studied. In 83% of patients, BPS was caused by muscle tonic syndrome and in 17% the latter was combined with radiculopathy. Meloxicam therapy was conducted using intramuscular injections of 15 mg daily during 5 days with following oral drug intake (1 tablet daily). Treatment duration was 2 weeks. This treatment regime proved to be highly effective. The subjective meloxicam efficacy was the following: moderate--7%; good--30%; very good--33%; excellent--30%. Side effects, such as transient stomach pain, was observed only in 6.6% of patients. The main factors reducing meloxicam efficacy were affective disorders, namely, a level of depression and anxiety, and radiculopathy.

Topics: Acute Disease; Administration, Oral; Adult; Anti-Inflammatory Agents, Non-Steroidal; Anxiety; Depression; Drug Administration Schedule; Female; Humans; Injections, Intramuscular; Low Back Pain; Male; Meloxicam; Middle Aged; Muscle, Skeletal; Psychology; Radiculopathy; Surveys and Questionnaires; Thiazines; Thiazoles; Treatment Outcome

In this controlled, randomised, parallel-group, multicentre study, the efficacy and tolerability of an intramuscular (i.m.) dose of meloxicam (15 mg) on Day 1 followed by seven days of oral meloxicam (15 mg/day) were compared with those of an i.m. dose of piroxicam (20 mg) on Day 1 followed by seven days of oral piroxicam (20 mg/day) therapy in a total of 169 outpatients with acute lumbago. Time to onset of analgesic action after i.m. injection was determined, and overall efficacy, pain on movement, limitation of daily activities, local tolerability at the injection site and overall tolerability were assessed by investigators and patients on verbal rating scales (VRSs). Adverse events and laboratory assessments were documented. Meloxicam and piroxicam showed a rapid onset of action after i.m. injection (40 and 45 minutes median time, respectively), overall efficacy of both therapies was highly rated, and limitations to daily life were greatly reduced in the majority of patients in both groups. There were no statistically significant differences in efficacy between meloxicam and piroxicam. Local and overall tolerabilities were equally good for the two drugs, but there were fewer gastrointestinal (GI) adverse events among meloxicam patients (1.2% of patients) than piroxicam patients (7.0% of patients). The improved tolerability profile of meloxicam may be explained by its selectivity towards cyclooxygenase-2.

Topics: Activities of Daily Living; Acute Disease; Administration, Oral; Adult; Anti-Inflammatory Agents, Non-Steroidal; Chi-Square Distribution; Drug Administration Schedule; Female; Humans; Injections, Intramuscular; Low Back Pain; Male; Meloxicam; Middle Aged; Movement; Pain; Pain Measurement; Piroxicam; Thiazines; Thiazoles

In this controlled, randomized, parallel and open multicentre study, the efficacy and tolerability of a regimen comprising intravenous (i.v.) meloxicam followed by oral therapy was compared with a standard regimen of intramuscular (i.m.) diclofenac followed by oral dosing in patients with acute lumbago. Of a total of 183 patients, 92 were randomized to receive meloxicam 15 mg i.v. on day 1 followed by 7 days oral treatment with one 15 mg tablet daily, and 91 patients received diclofenac 75 mg i.m. on day 1 followed by 7 days treatment with one 100 mg slow release tablet daily. Pain on movement and limitation of activities were assessed by patients and physicians using questionnaires. Meloxicam i.v. demonstrated a significantly faster median time of onset of analgesic action (30 minutes), compared with diclofenac i.m. (60 minutes). The reduction in pain during movement 30 minutes after injection was also significantly in favour of meloxicam. Assessments of global efficacy indicated that meloxicam was significantly better than diclofenac as rated by investigators (p = 0.02) and patients (p = 0.01). Moreover, the rating of investigators and patients for local and global tolerance was significantly in favour of meloxicam (p < 0.05) and improvements in the quality of life were almost significant (p = 0.053). Fewer adverse events, particularly of a gastrointestinal (GI) nature, occurred in the meloxicam group compared with the diclofenac group. This study therefore demonstrates that meloxicam 15 mg i.v. followed by oral therapy is both efficacious and well tolerated in the treatment of acute lumbago, and compares favourably with the standard NSAID, diclofenac, in this indication.

Topics: Administration, Oral; Adult; Anti-Inflammatory Agents, Non-Steroidal; Delayed-Action Preparations; Diclofenac; Drug Tolerance; Female; Humans; Injections, Intramuscular; Injections, Intravenous; Low Back Pain; Male; Meloxicam; Middle Aged; Thiazines; Thiazoles

To evaluate the effectiveness of the effect of celecoxib and the combined vitamin complex of group B in comparison with meloxicam in patients with acute and chronic nonspecific lumbar pain (LP).. The effectiveness of the effect on acute (44%; acute pain syndrome (APS)) and chronic (56%; chronic pain syndrome (CPS)) LP of moderate intensity (according to VAS/MPQ) (APS 5.7±2.3/2.13±0.67 points; CPS 5.2±2.8/1.47±0.61 points), the leading component of which is sensory sensations (when APS is lower than in CBS; Kr-W=6.15,. It was found that celecoxib and meloxicam cause the same significant remitting decrease in the severity of APS and restoration of MF disorders in patients with APS, equally cause rare adverse events (gastropathy, increased blood pressure) in comorbid pathology. Celecoxib proved to be more effective in relieving CPS and improving MF (. The results of the study confirm the benefits of celecoxib in combination with a vitamin complex for the relief of CPS.. Оценить эффективность влияния целекоксиба и комбинированного витаминного комплекса группы B в сравнении с мелоксикамом у пациентов с острой и хронической неспецифической поясничной болью (ПБ).. Оценена эффективность влияния на острую (44%; острый болевой сисндром (ОБС)) и хроническую (56%; хронический болевой синдром (ХБС)) ПБ умеренной интенсивности (по ВАШ/MPQ) (ОБС — 5,7±2,3/2,13±0,67 балла; ХБС — 5,2±2,8/1,47±0,61 балла), ведущей составляющей которой являются сенсорные ощущения (при ОБС ниже, чем при ХБС; Kr-W=6,15,. Установлено, что целекоксиб и мелоксикам вызывают сопоставимое значимое снижение выраженности ОБС и восстановление нарушений ДФ у пациентов с ОБС, в равной степени вызывают редкие нежелательные явления (гастропатию, повышение артериального давления) при коморбидной патологии. Целекоксиб оказался эффективнее при купировании ХБС и для улучшения ДФ (. Результаты исследования подтверждают преимущества целекоксиба в сочетании с витаминным комплексом при купировании ХБС.

Topics: Adult; Celecoxib; Chronic Pain; Female; Humans; Low Back Pain; Male; Meloxicam; Middle Aged; Pain Measurement; Vitamin B Complex

To compare the efficacy and tolerability of different combinations of domestic generics meloxicam (amelotex), tolperisone (calmirex) and B vitamins (compligam B) in the treatment of acute low-back pain.. Ninety patients with acute low-back pain (ICD-10 M54.5) were studied. Indications and prescribing of the drugs was carried out under the international generic name. Pain was assessed using a visual analog pain scale in mm (VAS). To relieve pain, all patients received the non-steroidal anti-inflammatory drug with a favorable safety profile meloxicam (amelotex). With the aim of optimization, 3 therapy regimens were proposed: group 1 (. During treatment, all groups showed a significant regression of pain according to VAS: in group 1 from 77 to 9 mm, in group 2 from 74 to 12 mm, in group 3 from 69 to 14 mm. The maximum statistically significant reduction in pain and the degree of muscle tone was observed in group 1. Adverse reactions occurred in all groups, but they were weak and transient, and did not require correction or discontinuation of therapy. Only one patient from group 3 had a persistent rise in blood pressure. The average duration of temporary disability was 5.8 days in group 1, 7.4 in group 2, and 9.5 days in group 3. High efficacy and good tolerability of all 3 therapy regimens were noted. The combination of amelotex, calmirex and compligam B received the highest rating in the opinion of doctors and patients.. All 3 treatment regimens optimize therapy in patients with acute low-back pain, reduce the dose and timing of the NSAID administration as well as the risk of adverse reactions. The results indicate that the combination of amelotex, calmirex and compligam B is a synergy of three pain relief systems due to the effect on different pathogenetic mechanisms, thereby providing the maximum analgesic effect, shortening the course of treatment and duration of temporary disability, reducing the risk of relapse and chronicity of pain.. Сравнительный анализ эффективности и переносимости различных комбинаций отечественных дженериков мелоксикама (амелотекса), толперизона (калмирекса) и витаминов группы В (комплигам В) в лечении острой боли в нижней части спины.. Обследованы 90 больных с острой болью в нижней части спины с диагнозом М54.5. Назначение и выписка лекарственных препаратов проводились по международному непатентованному наименованию. Оценку болевого синдрома осуществляли по визуальной аналоговой шкале боли в мм (ВАШ). Для купирования болевого синдрома всем пациентам назначался нестероидный противовоспалительный препарат с благоприятным профилем безопасности — мелоксикам (амелотекс). С целью оптимизации лечения были предложены 3 схемы терапии: 1-я группа (. На фоне лечения во всех группах наблюдался существенный регресс болевого синдрома по ВАШ: в 1-й группе с 77 до 9 мм, во 2-й группе с 74 до 12 мм, в 3-й группе с 69 до 14 мм. Максимальная статистически значимая редукция боли и степени мышечного тонуса отмечалась в 1-й группе. Нежелательные реакции встречались во всех группах, но были выражены слабо, носили преходящий характер, не требовали коррекции или отмены терапии. Только у 1 пациента из 3-й группы отмечался стойкий подъем артериального давления. Средняя длительность временной нетрудоспособности составила в 1-й группе 5,8 дня, во 2-й группе 7,4 дня, в 3-й группе 9,5 дня. Отмечены высокая эффективность и хорошая переносимость всех 3 схем терапии. Комбинация амелотекса, калмирекса и комплигам В получила самую высокую оценку, по мнению врачей и пациентов.. Все 3 схемы лечения позволяют оптимизировать терапию у пациентов с острой поясничной болью, сократить дозу, сроки приема нестероидного противовоспалительного препарата и уменьшить риск нежелательных реакций. Полученные данные свидетельствуют, что комбинация амелотекса, калмирекса и комплигам В за счет воздействия на разные патогенетические механизмы представляет собой синергию трех систем купирования боли, благодаря чему обеспечивает максимальный противоболевой эффект, сокращает курс лечения и длительность временной нетрудоспособности, снижает риск рецидива и хронизации боли.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Humans; Low Back Pain; Meloxicam; Tolperisone; Treatment Outcome

Synovial cysts are most commonly found in the lumbar spine and are associated with low back pain and radiculopathy. Frequent use of imaging modalities has led to an increase in intraspinal synovial cyst identification. Treatment typically ranges from conservative measures to surgical decompression, but spontaneous resolution has previously been reported. Here, we present the first report of symptomatic lumbar synovial cyst resolution after a traumatic fall.. We present a case of a symptomatic synovial cyst between the fourth (L4) and fifth (L5) lumbar vertebrae identified on magnetic resonance imaging (MRI). The patient presented with right paramedian back pain and right-sided L5 radiculopathy. She underwent unsuccessful trials of antiinflammatory agents and physical therapy. Less than 1 year since initial diagnosis, the patient sustained a mechanic fall followed by resolution of prior symptoms. A subsequent lumbar MRI revealed complete resolution of the intraspinal synovial cyst.. The diagnosis of synovial cysts are increasing in frequency due to their ease of identification with computed tomography and MRI. For cases of refractory pain and/or neurologic deficits, surgical decompression is usually necessary. In rare instances, synovial cysts may spontaneously regress or resolve secondary to other events. This is the first description of resolution after a traumatic fall. Due to limited data on this topic, this report may provide additional insight into the pathophysiology of synovial cyst formation and resolution.

Topics: Accidental Falls; Anti-Inflammatory Agents, Non-Steroidal; Female; Humans; Low Back Pain; Lumbar Vertebrae; Magnetic Resonance Imaging; Meloxicam; Middle Aged; Physical Therapy Modalities; Radiculopathy; Remission, Spontaneous; Spinal Stenosis; Synovial Cyst; Treatment Failure; Zygapophyseal Joint

Chronic low back pain (LBP) and sciatica can occur without obvious structural causes and are often resistant to conventional analgesic drugs. The effect of periradicular injection of meloxicam on LBP with or without a radicular component was assessed. A secondary objective of this prospective observational study was to assess the effect of meloxicam on functional recovery.. Seventy-two patients (30 men, 42 women) with LBP and/or sciatica were followed for 90 days to six years after injecting 10 mg meloxicam in 10 mL saline at each of the involved dermatomal levels. A standard verbal rating scale (VRS) from 0=no pain to 10=severe pain was used for assessing LBP before the injection of meloxicam (at baseline) and at 1, 5, 10, 30 and 60 min, and 1, 5, 15, 30 and 90 days intervals after the injection. The meloxicam injection was repeated only if the VRS score remained >3. Rescue analgesic requirements and functional activity levels were also assessed from 30-90 days after the last injection of meloxicam.. The mean baseline LBP score was 8.60 ± 1.50 (SD) despite the use of multi-modal analgesic regimens (NSAIDs, glucocorticosteroids, paracetamol, oral opioids, gabapentanoid compounds, epidural or periradicular steroid and/or local anesthetics) as well as laser treatments and physical therapy. The majority of patients reported that their pain intensity decreased by ~50% 1-2 min after the meloxicam injection was completed. Thirty-six patients (50%) required no further injections, 25 patients (35%) required a second injection after seven days, and 11 patients (15%) required a total of three injections. After the meloxicam treatment(s), only 10 patients (14%) required "rescue" analgesia with oral NSAIDs. All patients were able to increase their level of functional activity after the meloxicam treatment(s).. Periradicular injections of meloxicam (10 mg) appear to be a useful alternative to opioid and non-opiod analgesics for patients with intractable LBP due to nerve root inflammation.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Female; Humans; Injections; Low Back Pain; Male; Meloxicam; Middle Aged; Pain Measurement; Prospective Studies; Sciatica; Spinal Nerve Roots; Thiazines; Thiazoles; Treatment Outcome; Young Adult

Topics: Acute Disease; Anti-Inflammatory Agents, Non-Steroidal; Cyclooxygenase Inhibitors; Humans; Low Back Pain; Meloxicam; Thiazines; Thiazoles

In regard to therapeutic effect of different medications used in dorsopathy treatment, non-steroid anti-inflammatory drugs rank first. Compounds selectively blocking COX-2 received special attention due to their minimal impact on COX-1 that provides good anti-inflammatory and analgesic effect with simultaneous dramatic reduction of ulcerogenic activity. One of the first drugs with such an action is Movalis (meloxicam). Thirty patients were divided into 2 groups, the first including 22 patients with vertebral diseases and musculotonic syndromes; patients of the second group (8) had a pain syndrome caused by disk herniation. During the first 3 days Movalis was administered in the form of injections (15 mg/day) and in the same doses in tablets for the following 20 days. After the treatment course, complete arrest of pain syndrome was observed in 33.3% patients, significant improvement--in 53.3% and insignificant effect--in 13.3%. Patients with reflex pain and musculotonic syndromes had a good analgesic effect after 3-day course of intramuscular injections, with the effect being mostly expressed in 8-10 days. Patients with diskogenic compressive radicular syndrome demonstrated a stable analgesic effect after a week of Movalis intake in tablet form. Movalis is well tolerated; side effects have occurred in 10 patients but they were minimal and did not lead to the change of medication dose or additional therapy.

Topics: Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Back Pain; Cyclooxygenase Inhibitors; Female; Humans; Injections, Intramuscular; Intervertebral Disc Displacement; Low Back Pain; Male; Meloxicam; Middle Aged; Osteochondritis; Pain Measurement; Spinal Diseases; Spondylarthropathies; Tablets; Thiazines; Thiazoles; Time Factors; Treatment Outcome

Topics: Anti-Inflammatory Agents, Non-Steroidal; Humans; Injections, Intramuscular; Low Back Pain; Meloxicam; Thiazines; Thiazoles

Topics: Acute Disease; Administration, Oral; Cyclooxygenase 2; Cyclooxygenase 2 Inhibitors; Cyclooxygenase Inhibitors; Humans; Injections, Intramuscular; Isoenzymes; Low Back Pain; Meloxicam; Membrane Proteins; Piroxicam; Prostaglandin-Endoperoxide Synthases; Randomized Controlled Trials as Topic; Thiazines; Thiazoles

To assess the response to nonsteroid antiinflammatory drug movalis in LBP syndrome.. Movalis was given in daily dose 15 mg for 7 days, then 7.5 mg daily for 14 days to 22 patients with LBS aged 34-56 years. All the patients had lumbosacral intervertebral osteochondrosis complicated with secondary radiculitis or myofascial syndrome.. Movalis noticeably relieved pain syndrome. At the end of the treatment two-thirds of the patients were able to move. Tolerance of the drug was good, satisfactory and bad in 10, 7 and 1 patients, respectively.. Movalis is effective in LBP syndrome.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Disability Evaluation; Female; Humans; Isoenzymes; Low Back Pain; Male; Meloxicam; Middle Aged; Osteochondritis; Pain Measurement; Radiculopathy; Spinal Diseases; Thiazines; Thiazoles; Treatment Outcome