mobic and Radiculopathy

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

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

Painful neuropathic injuries are accompanied by robust inflammatory and oxidative stress responses that contribute to the development and maintenance of pain. After neural trauma the inflammatory enzyme cyclooxygenase-2 (COX-2) increases concurrent with pain onset. Although pre-treatment with the COX-2 inhibitor, meloxicam, before a painful nerve root compression prevents the development of pain, the pathophysiological mechanisms are unknown. This study evaluated if pre-treatment with meloxicam prior to painful root injury prevents pain by reducing spinal inflammation and peripheral oxidative stress. Glial activation and expression of the inflammatory mediator secreted phospholipase A

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Antioxidants; Astrocytes; Cervical Cord; Disease Models, Animal; Ganglia, Spinal; Inflammation; Male; Meloxicam; Microglia; Neurons; Oxidative Stress; Pain; Peripheral Nervous System Diseases; Radiculopathy; Rats, Sprague-Dawley; Spinal Nerve Roots

Although neck and low-back pain are common sources of neuropathic pain with high societal costs, the pathophysiology of neuropathic pain is not well-defined. Traditionally, most rodent pain studies rely on evoked reflex-based testing to measure pain. However, these testing methods do not reveal spontaneous pain, particularly early after injury. The rat grimace scale (RGS) for quantifying spontaneous pain has been validated after visceral, incisional, orthopedic, and inflammatory insults but not neuropathic pain. The current study used a rat model of radiculopathy to investigate the time course of RGS, the effect of the NSAID meloxicam on RGS, and the reliability and consistency of RGS across testers. RGS values at baseline and at 3, 6, 24, and 48 h after cervical nerve root compression (NRC) that induced robust evoked pain responses were compared with those obtained after sham surgery. The RGS was also evaluated at 6 h after NRC in another set of rats that had received meloxicam treatment prior to surgery. At 6 h, NRC induced higher RGS scores (1.27 ± 0.18) than did sham surgery (0.93 ± 0.20), and scores remained above baseline for as long as 48 h. Treatment with meloxicam before NRC reduced RGS at 6 h to sham levels, which were lower than those of injury without treatment. The RGS was associated with very good interobserver reliability (intraclass correlation coefficient, 0.91) and excellent internal consistency (Cronbach α, 0.87). These findings suggest that RGS is a useful approach to identifying and monitoring acute neuropathic pain in rats.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Disease Models, Animal; Facial Expression; Male; Meloxicam; Neuralgia; Pain Measurement; Radiculopathy; Rats; Rats, Sprague-Dawley; Reproducibility of Results; Thiazines; Thiazoles; Time Factors; Video Recording

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