Treatment of chronic cervicobrachial pain with periradicular injection of meloxicam

Background: Cervicobrachial pain (CBP) is often resistant to conventional oral analgesics. We hypothesized that periradicular injection of meloxicam would produce a significant reduction in intractable CBP. The secondary objective was to assess the impact on functional recovery. Methods: 48 patients with persistent CBP despite multimodal analgesic therapy received 1-3 periradicular injections of meloxicam, 5-20 mg, at the dermatomal level(s) corresponding to their pain symptoms. Pain level (0=none to 10=severe), rescue analgesics and functional activity were recorded at baseline for 90 days after the last injection. The injection was repeated if the pain score remained >3 or paraesthesia persisted. Results: The mean pain score was reduced from a baseline of 8.9 (±1, SD) to 1.7 (±2.2, SD) at 90 days after the last meloxicam injection. After the meloxicam treatment(s), only 13% of the patients required oral analgesics as rescue medication. All patients increased their functional activity level. Conclusion: Cervical periradicular injection of meloxicam reduced CBP by 81% at 90d and improved functional recovery.