Pentoxifylline significantly reduces radicular pain secondary to lumbar disc hernia: A prospective, randomized crossover, single-blind controlled pilot study

Optimal medical treatment for low back pain, sometimes associated to radicular pain, has yet to be established. Herniated nucleus pulposus has been found to release TNFα, a pro-inflammatory cytokine involved in radiculopathy. Interestingly, Pentoxifylline (PTX), a phosphodiesterase inhibitor, blocks...

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Published in:Clinical neurology and neurosurgery 2022-08, Vol.219, p.107309-107309, Article 107309
Main Authors: Tarabay, Bilal, Komboz, Fares, Kobaïter-Maarrawi, Sandra, Fayad, Fouad, Zeid, Hicham Abou, Maarrawi, Joseph
Format: Article
Language:English
Subjects:
Analgesics
Anti-inflammatory agents
Back pain
Consent
Degenerative disc disease
Disease
Hernia
Ibuprofen
Inflammation
Intervertebral discs
Low back pain
Lumbar disc herniation
Medical treatment
Nucleus pulposus
Paracetamol
Patients
Pentoxifylline
Phosphodiesterase
Phosphodiesterase inhibitors
Radiculopathy
Sciatica
Statistical analysis
Substance abuse treatment
Surgery
Tumor necrosis factor-TNF
Tumor necrosis factor-α
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Summary:Optimal medical treatment for low back pain, sometimes associated to radicular pain, has yet to be established. Herniated nucleus pulposus has been found to release TNFα, a pro-inflammatory cytokine involved in radiculopathy. Interestingly, Pentoxifylline (PTX), a phosphodiesterase inhibitor, blocks the activity of TNFα. The aim of this study is to assess the effectiveness of PTX when added to the treatment protocol of radiculopathy in lumbar disc herniation. Fifty-eight patients with radicular pain secondary to a lumbar disc hernia were included in this prospective, randomized crossover, single-blind controlled study. PTX was added randomly to the same treatment protocol (ibuprofen + paracetamol + pregabalin) either during the first or the second 15 days of treatment. Patients’ pain was assessed at day 15 via the Numeric Rating Scale (NRS) and the Patient’s Global Impression of Change score (PGIC). D15 NRS value was considered as the primary outcome measure. Mean D15 NRS score was 3.2 ± 0.84 during the 15-days treatment with PTX, and 5,1 ± 0.97 during the 15-days treatment without PTX (p 
ISSN:0303-8467
1872-6968
DOI:10.1016/j.clineuro.2022.107309