Treatment for low back pain, use of meloxicam
https://doi.org/10.14412/2074-2711-2015-3-51-56
Abstract
To manage patients with low back pain is an urgent problem of modern medicine. The paper considers the main causes of chronic nonspecific lumbago and the principles of its diagnosis and treatment in the context of evidence-based medicine. Medical treatment using analgesics (nonsteroidal anti-inflammatory drugs (NSAIDs), weak opioids), antidepressants, therapeutic exercises, and cognitive-behavioral therapy as components of a multidisciplinary treatment is noted to be highly effective. The efficacy and side effects of NSAIDs, the high efficiency and safety of using meloxicam in different dosage forms are outlined.
The authors set forth their experience in treating 85 patients with chronic low back pain and an observation of a female patient who has concurrent chronic migraine and abuses analgesics.
About the Authors
E. Yu. Suslova
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Department of Nervous System Diseases and Neurosurgery, Faculty of Therapeutics,
11, Possolimo St., Build. 1, Moscow 119435
V. A. Parfenov
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Department of Nervous System Diseases and Neurosurgery, Faculty of Therapeutics,
11, Possolimo St., Build. 1, Moscow 119435
References
1. Подчуфарова ЕВ, Яхно НН. Боли в спине и конечностях. В кн.: Болезни нервной системы. Руководство для врачей. Под ред. Н.Н. Яхно. Москва: Медицина; 2005. Т.2. С. 306—31. [Podchufarova EV, Yakhno NN. Pain in the back and limbs. In: Bolezni nervnoi sistemy. Rukovodstvovo dlya vrachei [Diseases of the nervous system. A guide for physicians]. Yakhno NN, editor. Moscow: Meditsina; 2005. Vol. 2. P. 306-31.]
2. Подчуфарова ЕВ, Яхно НН. Боль в спине. Москва: ГЭОТАР-Медиа; 2013. 368 с. [Podchufarova EV, Yakhno NN. Bol' v spine [Pain in the back]. Moscow: GEOTAR-Media; 2013. 368 p.]
3. Вахнина НВ. Хроническая пояснично-крестцовая боль: диагностика и лечение. Неврология, нейропсихиатрия, психосоматика. 2010;2(3):30-4. [Vakhnina NV. Chronic lumbosacral pain: diagnosis and treatment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2010;2(3):30-4. (In Russ.)]. DOI: http://dx.doi.org/10.14412/2074-2711-2010-97
4. Цурко ВВ. Пожилой возраст и боль в спине. Сonsilium Medicum. 2006;(8):35-7. [Tsurko VV. Old age and back pain. Consilium Medicum. 2006;(8):35-7. (In Russ.)].
5. Алексеев ВВ, Яхно НН. Основные синдромы поражения нервной системы. В кн.: Болезни нервной системы. Руководство для врачей. Под ред. Яхно Н.Н., Штульмана Д.Р. Москва: Медицина; 2001. Т.1. С. 106-24. [Alekseev VV, Yakhno NN. Main syndromes of nervous system affections. In: Bolezni nervnoi sistemy. Rukovodstvovo dlya vrachei [Diseases of the nervous system. A guide for physicians]. Yakhno NN, Shtul'man DR, editors. Moscow: Meditsina; 2001. Vol. 1. P. 106-24].
6. Airaksinen O, Brox JI, Cedraschi C, et al. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006 Mar;15 Suppl 2:S192-300.
7. Aoki Y, Sugiura S, Nakagawa K, et al. Evaluation of nonspecific low back pain using a new detailed visual analogue scale for patients in motion, standing, and sitting: characterizing nonspecific low back pain in elderly patients. Pain Research and Treatment. Pain Res Treat. 2012;2012:680496. doi: 10.1155/2012/680496. Epub 2012 Nov 18.
8. Van Tulder M, Becker A, Bekkering T, et al. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J. 2006 Mar;15 Suppl 2:S169-91.
9. Ferrell B, Argoff CE, Epplin J, et al. Pharmacological management of persistent pain in older persons. American geriatrics society panel on the pharmacological management of persistent pain in older persons. J Am Geriatr Soc. 2009 Aug;57(8):1331-46. doi: 10.1111/j.1532-5415.2009.02376.x. Epub 2009 Jul 2.
10. Singh G. Recent considerations in nonsteroidal anti-inflammatory gastropathy. Am J Med. 1998 Jul 27;105(1B):31S-38S.
11. Birbara CA, Puopolo AD, Munoz DR, et al. Treatment of chronic low back pain with etoricoxib, a new cyclo-oxygenase-2 selective inhibitor: improvement in pain and disability – a randomized, placebo-controlled, 3-month trial. J Pain. 2003 Aug;4(6):307-15.
12. Насонов ЕЛ. Современное учение о селективных ингибиторах ЦОГ-2: новые аспекты применения мелоксикама (мовалиса). Научно-практическая ревматология. 2001;39(1):58-62. [Nasonov EL. The modern doctrine of selective COX-2 inhibitors: new aspects of the use of meloxicam (Movalis). Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2001;39(1):58-62. [(In Russ.)].
13. Brooks P, Emery P, Evans JE, et al. Interpreting the clinical significance of the differential inhibition of cyclooxigenase-l and cyclooxigenase-2. Rheumatology (Oxford). 1999 Aug;38(8):779-88.
14. Feldman M, McMachon AT. Do cyclooxigenase-2 inhibitors provide benefits similar to those of traditional nonsteroidal antimflammatory drugs, with less gastrointerstinal toxicity? Ann Intern Med. 2000 Jan 18;132(2):134-43.
15. Warner TD, Mitchell JA. Cyclooxygenases: new forms, new inhibitors, and lessons from the clinic. FASEB J. 2004 May;18(7):790-804..
16. Clark DW, Layton D, Shakir SA. Do some inhibitors of COX-2 increase the risk of thromboembolic events?: Linking pharmacology with pharmacoepidemiology. Drug Saf. 2004;27(7):427-56.
17. Brune K, Patrignani P. New insights into the use of currently available non-steroidal antiinflammatory drugs. J Pain Res. 2015 Feb 20;8:105-18. doi: 10.2147/JPR.S75160. eCollection 2015.
18. Meek IL, Vonkeman HE, Kasemier J, et al. Interference of NSAIDs with the thrombocyte inhibitory effect of aspirin: a placebo-controlled, ex vivo, serial placebo-controlled serial crossover study. Eur J Clin Pharmacol. 2013 Mar;69(3):365-71. doi: 10.1007/s00228-012-1370-y. Epub 2012 Aug 14.
19. Kaplan-Machlis В, Klostermeyer BS. The cyclooxigenase-2 inhibitors: safety and effectiveness. Ann Pharmacother. 1999 Sep;33(9):979-88.
20. Hawkey C, Kahan A, Steinbruck K, et al. Gastrointestinal tolerability of meloxicam compared diclofenac in osteoarthritis patients. International MELISSA Study Group. Meloxicam Large-scale International Study Safety Assessment. Br J Rheumatol. 1998 Sep;37(9):937-45.
21. Singh G, Lanes S, Triadafilopoulos S. Risk of serious upper gastrointestinal and cardiovascular thromboembolic complications with meloxicam. Am J Med. 2004 Jul 15;117(2):100-6.
22. Мазуров ВИ. Применение мелоксикама (Мовалиса) у больных с ревматическими заболеваниями с сопутствующей ишемической болезнью сердца. Клиническая медицина. 2004;(12):54—9. [Mazurov VI. The use of meloxicam (Movalis) in patients with rheumatic disease with concomitant coronary artery disease. Klinicheskaya meditsina. 2004;(12):54-9. (In Russ.)].
23. Chen YF, Jobanputra P, Barton P, et al. Cyclooxygenase-2 selective non-steroidal antiinflammatory drugs (etodolac, meloxicam, celecoxib, rofecoxib, etoricoxib, valdecoxib and lumiracoxib) for osteorthritis and rheumatoid arthritis: a systematic review and economic evaluation. Health Technol Assess. 2008 Apr;12(11):1-278, iii.
24. Герасимова ОН, Парфенов ВА. Клинический опыт применения мелоксикама (мовалис) при неспецифической боли в спине и радикулопатии. Неврология, нейропсихиатрия, психосоматика. 2012;4(2):68-73. [Gerasimova ON, Parfenov VA. Clinical experience with meloxicam (Movalis®) in nonspecific back pain and radiculopathy. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;4(2):68-73. (In Russ.)]. DOI: http://dx.doi.org/10.14412/2074-2711-2012-387
25. Dreiser RL, Le Parc JM, Vеlicitat P, Lleu PL. Oral meloxicam is effective in acute sciatica: two randomised, double-blind trials versus placebo or diclofenac. Inflamm Res. 2001 Mar;50 Suppl 1:S17-23.
26. Gonzalez Maza C, Moscoso Lopez L, Ramirez Elizalde G, Abdo Andrade A. Multimodal treatment of chronic unspecific low back pain. Acta Ortop Mex. 2010 MarApr;24(2):88-94.
27. Насонова ВА, Воробьев ПА, Цветкова ЕС, Аксеньтева МВ. Фармакоэкономический анализ применения двух нестероидных противовоспалительных препаратов в ревматологии. Научно-практическая ревматология. 2002;40(1):63—8. [Nasonova VA, Vorob'ev PA, Tsvetkova ES, Aksen'teva MV. Pharmaeconomic analysis of application of two non-steroid antiinflammatory drugs in rheumatology. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2002;40(1):63-8. (In Russ.)]. DOI: http://dx.doi.org/10.14412/1995-4484-2002-754
28. Лукина ЕВ, Колоколов ОВ, Колоколова АМ. Болевой синдром: возможности использования миорелаксантов. Русский медицинский журнал. 2013;(16):852-6. [Lukina EV, Kolokolov OV, Kolokolova AM. Pain: the possibility of using muscle relaxants. Russkii meditsinskii zhurnal. 2013;(16):852-6. (In Russ.)].
29. Attal N, Cruccu G, Baron R, et al. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2010 Sep;17(9):1113-e88. doi: 10.1111/j.1468-1331.2010.02999.x. Epub 2010 Apr 9.
30. Подчуфарова ЕВ. Дискогенная пояснично-крестцовая радикулопатия. Неврология, нейропсихиатрия, психосоматика. 2010;2(3):22-9. [Podchufarova EV. Discogenic lumbosacral radiculopathy. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2010;2(3): 22-9. (In Russ.)]. DOI: http://dx.doi.org/10.14412/2074-2711-2010-96
31. Мелкумова КА. Когнитивно-поведенческая психотерапия при лечении хронической боли. Неврология, нейропсихиатрия, психосоматика. 2010;2(1):9-13. [Melkumova KA. Cognitive behavioral psychotherapy in the treatment of chronic pain. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2010;2(1):9-13. (In Russ.)]. DOI: http://dx.doi.org/10.14412/2074-2711-2010-63
32. Gatchel RJ, Rollings KH. Evidence informed management of chronic low back pain with cognitive behavioral therapy. Spine J. 2008 Jan-Feb;8(1):40-4. doi: 10.1016/j.spinee.2007.10.007.
33. Staal JB, Hlobil H, Twisk JW, et al. Graded activity for low back pain in occupational health care: a randomized, controlled trial. Ann Intern Med. 2004 Jan 20;140(2):77-84.
34. Sveinsdottir V, Eriksen HR, Reme SE. Assessing the role of cognitive behavioral therapy in the management of chronic nonspecific back pain. J Pain Res. 2012;5:371-80. doi: 10.2147/JPR.S25330. Epub 2012 Oct 11.
35. Chou R, Huffman LH; American Pain Society; American College of Physicians. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 2007 Oct 2;147(7):492-504.
36. Исайкин АИ. Скелетно-мышечная боль в пояснично-крестцовой области. Неврология, нейропсихиатрия, психосоматика. 2011;3(2):34-41. [Isaikin AI. Musculoskeletal pain in the lumbosacral region. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2011;3(2):34-41. (In Russ.)]. DOI: http://dx.doi.org/10.14412/2074-2711-2011-144
37. Rho ME, Tang CT. The efficacy of lumbar epidural steroid injections: transforaminal, interlaminar, and caudal approaches. Phys Med Rehabil Clin N Am. 2011 Feb;22(1):139-48. doi: 10.1016/j.pmr.2010.10.006. Epub 2010 Dec 3.
Review
For citations:
Suslova EY, Parfenov VA. Treatment for low back pain, use of meloxicam. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2015;7(3):51-56. (In Russ.) https://doi.org/10.14412/2074-2711-2015-3-51-56
Views:
1196
Email this article 