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270 Neck and back pain – radicular syndromes
injection. A single dose of methylprednisolone (500 mg IV) significantly
reduces pain scores in RSP, but the effect is small in magnitude and limited
in duration (48 h at most). 21
n Summary and recommendations
First line: NSAIDs (e.g. meloxicam 7.5–15 mg PO QD, diclofenac 50 mg
PO TID)
Reasonable: opioids (e.g. oxycodone 5–10 mg PO q4–6 h, with or without
acetaminophen)
Pregnancy: acetaminophen 650–1000 mg PO QID; opioids (e.g. oxycodone 5–
10 mg PO q4–6 h)
Pediatric: NSAIDs (e.g. ibuprofen 10 mg/kg PO QID)
Special case:
n mild pain, patient not candidate for NSAIDs: low-potency opioid (e.g.
hydrocodone 2.5–5.0 mg PO q4–6h)
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