Clinical Notes – Long-Lasting Beneficial Effects Of Periradicular Injection Of Meloxicam For Treating Chronic Low Back Pain And Sciatica.
Minerva Anestesiol. 2013 Jan 10;
Authors: Borghi B, Aurini L, White PF, Mordenti A, Lolli F, Borghi R, Martignani M
BACKGROUND: Chronic low back pain (LBP) and sciatica can occur without obvious structural causes and is 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. METHODS: 72 patients (30 men, 42 women) with LBP and/or sciatica were followed for 90 days to 6 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. RESULTS: 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 7 days, and 11 patients (15%) required a total of 3 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 meloxican treatment(s). CONCLUSIONS: Periradicular injections of meloxicam (10 mg) appear to be a useful alternative to opioid and nonopiod analgesics for patients with intractable LBP due to nerve root inflammation.
PMID: 23306395 [PubMed – as supplied by publisher]