Piroxicam is used primarily for the treatment of rheumatoid diseases: piroxicam reduces pain, joint swelling and morning stiffness, and improves the functionality of the joints during chronic polyarthritis. As with other non-steroidal anti-inflammatory drugs, an influence on the development of the disease has not been demonstrated (only symptomatic effect). Pain is relieved in arthroses and joint mobility is improved. Whether this is advantageous for the affected joints in the long run, is not quite clear. Piroxicam has been compared to other anti-inflammatory agents (e.g. diclofenac, indomethacin, naproxen) in numerous controlled studies and proved to be equal and sometimes even more efficacious.

It can also be used for other rheumatoid diseases such as ankylosing spondylitis, (Bechterew's disease), acute gout, low back pain and soft tissue rheumatism (e.g. periarthropathy of the shoulder). It is thus sometimes advantageous that the drug is also available for intramuscular injection.

Piroxicam is also efficient for pain that is not related to the musculoskeletal system, e.g. dysmenorrhea or postoperative pain.

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