1967 Settel – Lumbosacral fibrositis

Key words: acute lumbosacral fibrositis

This is an article about lumbosacral fibrositis, another name for the entity also known as back mice. This article is from an American doctor named Edward Settel from New York. He starts his article saying:

Acute fibrositis of the low back area constitutes one of the most COMMON CLINICAL PICTURE seen in everyday medical and orthopedic practice”.

Phenylbutazone is an NSAID that is not used in humans anymore. It is used in animals. The patients received a combination of NSAID with corticoid and some other compounds.

He classifies the low back pain as: idiopathic, post-traumatic and related to OSTEOARTHRITIS.

He admits that there is no clear etiological factor in the case of idiopathic lumbosacral fibrositis, sometimes the patients do not refer any trauma or awkward motion, just that sometimes the patients mention that “THEY HAVE BEEN EXPOSED TO A “cold, drafty” environment.

Personal note: It is a very simple article, Dr. Settel says that he has 7 years of experience of using this combination of drug therapy and he presents the result for 96 patients. By the current research standards, it will be a WEAK STUDY.

He describes the symptoms very briefly; he does not explain anything about the patients (not even the sex or the age or the past history of pain). He doesn’t mention any exploration technique. It is just interesting from the historical point of view because it is clear that it normalized the oral therapy of “phenylbutazone”, a no steroidal anti-inflammatory drug (NSAIDs) for the treatment of low back pain as ibuprofen is used now. The phenylbutazone is forbidden in EUA for use in humans, but the concept of using other NSAIDs is completely contemporary nowadays.

EFFICACY OF A PHENYLBUTAZONE-PREDNISONE COMBINATION IN THE TREATMENT OF ACUTE LUMBOSACRAL FIBROSITIS: A SURVEY OF 96 CASES

Edward Settel, M.D.

Edward Settel states that ACUTE FIBROSITIS OF THE LOW BACK AREA (back mice) constitutes one of the most common clinical pictures seen in everyday medical practice.

He says that by then the common treatment ranged from: counterirritation to the techniques of heat, ultrasonic therapy, traction, manipulation, and oral and parental medications.

He states that one of the most useful treatments was STERAZOLIDIN (he refers to 3 medical references).

STERAZOLDIN capsules by Geigy Pharmaceuticals: each capsule contains 50mg phenylbutazone, 1.25mg prednisone, 100mg dried aluminium hydroxide gel, 150mg magnesium trisilicate, 1.25mg homatropine methylbromide.

acute umbosacral fibrositis

He stated that they use a combination of PHENYLBUTAZONE and PREDNISONE with good results. He presents the results of 7 years.

Patient selection: 96 patients with acute low-back pain syndrome (excluding DISCOID DISEASE).

  • 49 with acute lumbosacral fibrositis (idiopathic) or myofascitis
  • 35 with acute traumatic fibrositis
  • 12 fibrositis related to recurrent osetoarthritis

Idiopathic and traumatic form present in the same way: the patient presents the same complaint of sharp, radiating low-back pain, accompanied by surrounding muscle spasm, varying functional disability, and often, scoliosis. And the only difference between them is the past history of trauma.

Settle admits that the etiology of the lumbosacral fibrositis is OBSCURE. Some of the patients express that they have been exposed to a “cold drafty”.

The DOSAGE SCHEDULE that was highly effective according to Settle was (after a proper medical examination that included X-ray and blood test):

Sterazolidin in a TAPERING-OFF DOSAGE

-2 capsules/6h for 2 days

-1 capsule/6h for 2 days

acute lumbosacral fibrositis

Most cases show complete resolution, if not some further pills.

-t.i.d (3 times/day) for 2 days

-b.i.d (2 times/day) for some more days

According to Settle:

-47% of the idiopathic forms show excellent outcome

-74% of the traumatic forms show excellent outcome

-67% of the osteoarthritis forms show excellent outcome

He also says that they could not observe side effects.

Published in March 2019 by Marta Cañis Parera

References

-Settel E.E. Efficacy of a phenylbutazone-prednisone combination in the treatment of acute lumbosacral fibrositis. Current therapeutic research, clinicaland experimental. 1967. 9 (4) p 197-9. ISSN: 0011-393X.

-Barceló, P. Peralba, A.S. and Benach J.O.; A.I.R. 5:50-63, 1962.

-Desai, M.M.: Cr Med Pract. 7:771-776 1963.

-Bustamante, F.F. And Perdomo, A: Arch argent reum 24:15-18, 1961.