NSAIDs are effective for short-term relief of low-back pain

Jan 24 2008

Non steroidal anti-inflammatory drugs (NSAIDs; such as aspirin and ibuprofen) can help reduce symptoms of low back pain that doesn't involve sciatica, a Cochrane Systematic Review has found.

Low back pain is a major health problem in western industrialised countries, but there is little conclusive evidence about the best ways to treat it. NSAIDs are the most frequently prescribed medication worldwide, and are commonly given to people with low back pain. The hope is that they will not only reduce pain symptoms, but also reduce any inflammation in the back that may be the cause of the pain.

To evaluate the effectiveness of these drugs, Cochrane Researchers considered data from 65 trials that met their inclusion criteria. These involved a total of 11,237 people. They found that:

• NSAIDs were more effective at reducing pain than placebos, although the effects were small and NSAIDs were associated with more adverse effects.
• Different types of NSAID appeared to be equally effective.
• Short-term use of selective COX-2 inhibitors had fewer (gastrointestinal) side effects than the other NSAIDs.

The researchers also compared the effects of NSAIDs and paracetamol, another drug used by people with low back pain. They concluded that NSAIDs and paracetamol were equally effective at relieving acute low back pain, but paracetamol had fewer side effects.

“Physicians and patients with acute low back pain therefore have a choice about whether to use a NSAID or paracetamol, and the decision should be driven by individual clinical circumstances,” says lead author Pepijn Roelofs who works in the Department of general Practice at Erasmus University Medical Centre, Rotterdam, Netherlands.

“Most of these results came from studies of people who did not have sciatica, so we now need studies that look at whether NSAIDs have a role in helping those people as well,” says Roelofs.