reduced disability and increased global improvement from baseline to three weeks. Of note, the magnitude of the effect of NSAIDs over placebo on reduction of pain and disability did not meet the 10% threshold of clinical relevance. The impact of NSAIDs on adverse events and return to work was inconclusive due to very low-quality evidence. Limitations included possible industry bias since almost half of the included trials were supported by pharmaceutical companies.A 2017 evidence-and consensus-based clinical practice guideline on noninvasive treatments for low back pain from the American College of Physicians recommended either NSAIDs or skeletal muscle relaxants as the first-line options for acute or subacute low back pain if pharmacologic treatment is desired (strong recommendation based on moderatequality evidence from a 2017 systematic review). 2

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