Multimodal treatment of chronic unspecific low back pain

A prospective longitudinal was conducted using three multimodal treatment regimens that included a different NSAID for each of the regimens (thiaprofenic acid, piroxicam, meloxicam), a steroid (betamethasone) and a muscle relaxant (tetrazepam). 240 patients with a history of chronic low back pain for more than six months were treated; they were divided into three groups of 80 patients assigned to each regimen. Patients treated with thiaprophenic acid and meloxicam improved a total of 6 points, going from an initial mean score of 8 in the VAS at the onset of treatment, to a score of 2 at the end of treatment during a mean of 3 months. Patients treated with piroxicam had a 5-point improvement in the VAS, from a mean score of 7 at the onset of treatment to a mean score of 2 in a mean of 3 months. The meloxicam group had less epigastric complications, 1.25% compared with 2.91% for the thiaprophenic acid group and 3.75% for piroxicam. This combination, which includes an antiinflammatory agent, a steroid and a muscle relaxant, is an appropriate treatment regimen because it includes drugs that act on the antiinflammatory component, the pain component and the emotional component, which are the most common factors mentioned as probable causes of unspecific low back pain.