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Drugs may Not be the Best Treatment for Back Pain
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Drugs may Not be the Best Treatment for Back Pain

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Highlights:
  • Back pain is commonly treated with Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
  • The effectiveness of NSAIDs in spinal pain has not been established
  • The safety of NSAIDs is also an issue

Nonsteroidal Anti-inflammatory Drugs (NSAIDs) provide similar relief of spinal pain as compared to placebo, and at the same time were associated with side effects, finds a research team from Australia. Their research was published in the Annals of the Rheumatic Diseases.

Back pain is a common ailment for which people consult the doctor. The pain may arise from the bones, joints, ligaments, tendons, muscles or nerves of the back. Occupations that involve heavy physical activity with a lot of bending or twisting the back or lifting heavy weights are common causes of back pain. Conditions like fracture of the vertebrae, slipping out of intervertebral discs, osteoarthritis and rheumatoid arthritis are more serious causes of back pain. Conditions like kidney stones and endometriosis in females that affect abdominal organs can also present with back pain.

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While some of the causes of back pain like slipped disc could require surgical treatment, most cases of back pain are treated with exercises and painkillers. The non-steroidal anti-inflammatory drugs (NSAIDs) which include ibuprofen and diclofenac are often prescribed, while more severe pain may require treatment with opioids. Opioids have been found to provide only minimal relief as compared to placebo. Paracetamol is ineffective for spinal pain.

But are the NSAID painkillers really effective in the treatment of spinal pain? The research team analyzed 35 well-designed studies to understand the effect of NSAIDS in spinal pain, as well as their safety when used for this purpose. These studies included more than 6000 people. They found that:
  • NSAIDs did provide some relief against pain and disability caused by spinal pain, but the effectiveness was similar to that of a placebo
  • Six patients needed to be treated with NSAIDs to bring about significant pain relief in one patient
  • Despite the fact that the medications were used for a median of only seven days, the risk of gastrointestinal reactions such as stomach ulcers and bleeding increased two and a half times
Back pain can be prevented to a large extent by maintaining a proper posture and avoiding slouching. Exercises to strengthen the muscles of the back could also reduce back pain, and thereby medications can be avoided. Additional research is also necessary to come up with more simple, effective and safe drugs for the treatment of spinal pain.

Reference :
  1. Machado GC et al. Non-steroidal anti-inflammatory drugs for spinal pain: a systematic review and meta-analysis. Ann Rheum Dis doi:10.1136/annrheumdis-2016-210597
Source: Medindia

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