Q. Is it safe to take Nucoxia for a long period?

#

Hi,

Welcome to icliniq.com.

You have mentioned that you have been diagnosed as a case of mechanical back pain. Since your question is specific for Nucoxia, I can tell you that Etoricoxib is actually a COX-2 inhibitor which is definitely safer than conventional NSAIDs (non steroidal anti-inflammatory drugs). But, it should not be taken continuously for a period of three months. Also, you do not necessarily need an antacid with it, because it does not cause any acidity. But, if your are prone for it then there is no harm in taking an antacid like Omeprazole or Pantoprazole along with it. What I would advise to you is to take it for three to four weeksand then switch your medicine to an opioid like Tramadol, etc., and if needed then a muscle relaxant can be added on SOS basis (as and when necessary). Also, since your diagnosis is mechanical back pain, it needs more modification in your lifestyle, gentle anti-inflammatory medication for two to three weeks, adequate calcium and vitamin D intake, and regular and intensive physical therapy. Also, I would like to see your investigations such as x-ray and MRI scans if available for more discussion on your back pain.

Thank you.

# Hello Puneet,

Thanks for your query and welcome to Icliniq.

I have gone through your MRI films and it shows evidence of early Sacro- Ilitis.
So now our treatment approach will change because we need to actually rule out an inflammatory pathology which can lead to Sacroilitis.

Can you kindly send me your recent blood tests like CBC, ESR and CRP levels so that i can see whether any inflammatory marker is raised or not.
Also i will like to see your MRI images so that Sacro ilitis can be seen by me.

Once i have this information , i can then suggest what needs to be done further.
Also to tell you that this may be not be a part of mechanical back pain syndrome but a different issue.

Please get back to with these investigations or if you have done them recently.
Also till that time you are advised you to continue with anti inflammatory medication which you are taking and intensive physical therapy.

Thanks & Regards

---

Investigations to be done:

CBC, ESR and CRP
MRI films

Regarding follow up:

Follow up with investigations/SOS

# Hello Puneet,

Thanks for getting back to me.
I have gone through your reports and there are two things of mention :
Your CRP is slightly raised but all other inflammatory profile markers appear to be normal, so there is nothing to worry.

I think we can start with :

Physical Therapy : LASER therapy or Ultrasonics for Local application for 10-14 days
- Anti inflammatory medication which suits you , like Tab Etoricoxib as i had advised to you earlier
- If pain is acute, then Ice packs can be used initially for 3-5 days
- Dynapar QPS spray for Local application can be used after Ice fomentation

If this is not giving you any pain relief, then we can consider injecting you a local steroid injection for Pain relief, it is a simple procedure which can reduce inflammation in your SI joints.

Start with this treatment protocol and let me know in 2-3 weeks time how you are feeling.
Also try sending your MRI images as it will help me in understanding the situation better

Thanks & Regards

---

Treatment plan:

As advised

Regarding follow up:

Follow up after 2-3 weeks/SOS

# Hello Puneet,

Thanks for reaching out to me on Icliniq.

Since now we have tried conservative management in your case and it appears that it has not worked, i would like to clinically examine you in details before i can suggest you some thing else.

Also i would like to see your MRI images and other tests done by you.

Do not hesitate to get back to me should you need any further information/SOS

Thanks & Regards

---

Regarding follow up:

Follow with with a personal appointment for a thorough physical examination and further advice

---

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

---