Nonopioid pharmacological management of acute low back pain: A level I of evidence systematic review

Abstract

Acute low back pain (LBP) imposes a significant socioeconomical burden as it is the condition that, worldwide, cause the most disability. Nonetheless, the literature regarding the best pharmacological management of acute LBP is limited, and the indications available in the literature are conflicting. This work investigates whether the pharmacological management of acute LBP can effectively reduce pain and disability, and aims to identify which drugs show the highest efficacy. This systematic review was conducted according to the 2020 PRISMA statement. In September 2022, PubMed, Scopus, and Web of Science were accessed. All the randomized controlled trials investigating the efficacy of myorelaxants, nonsteroidal anti-inflammatory drugs (NSAIDs), and paracetamol for acute LPB were accessed. Only studies that investigated the lumbar spine were included. Only studies reporting on patients with acute LBP with symptom duration of less than 12 weeks were included. Only patients older than 18 years and with nonspecific low back pain were included. Studies that investigated the use of opioids in acute LBP were not considered. Data from 18 studies and 3478 patients were available. Myorelaxants and NSAIDs were effective in reducing pain and disability in acute LBP at approximately one week. The combination of NSAIDs and paracetamol was associated with a greater improvement than the use of NSAIDs alone, but paracetamol alone did not induce any significant improvement. Placebo was not effective in reducing pain. Clinical Significance: Myorelaxants, NSAIDs, and NSAIDs with paracetamol could reduce pain and disability in patients with acute LBP.acute, low back pain, lumbago, management | INTRODUCTIONLow back pain (LBP) is the musculoskeletal condition that causes the most disability worldwide. 1 The rate of first-ever episodes reaches 15%, with 80% of subjects experiencing an activity-imitating recurrence within 1 year. [2][3][4] In the United States, 25% of patients interviewed regarding common causes of pain reported having suffered from LBP in the 3 months before receiving the questionnaire. 5 LBP is defined as acute when symptoms last 2-12 weeks, 6,7 but up to 60% of patients will develop chronic LBP. 8,9 As first

NSAIDS versus electro-acupuncture in management of low back pain in patients with lumbar spondylosis: a comparative cohort study

“…Similarly, To Van Dut's research [6] from 2022 showed that the VAS index dropped from 7.1 to 4.2 after 15 days of treatment, which was statistically significant. Regarding the effectiveness of NSAIDS treatment, according to the findings of a meta-analysis study by Baroncini A [7], which showed a reduction from 6.9 to 2.0 following therapy (17.7 ± 24.9 days).…”

Vibration therapy to improve pain and function in patients with chronic low back pain: a systematic review and meta-analysis

“…LBP is one of the most common health problems among adults. Within 3 months, myorelaxants, nonsteroid anti-inflammatory drugs (NSAIDs), and NSAIDs with paracetamol can effectively reduce pain and disability in patients [ 28 ]. After 3 months, it can develop into CLBP.…”

Development of a low back pain care pathway in an academic hospital system: results of a consensus process

“…For example, The American College of Physicians (ACP) recommends non-pharmacological care as the first option for people with LBP [ 14 ]. Several non-pharmacological therapies, such as exercise and various manual therapies, demonstrate similar benefits to pharmacological therapies with comparatively less risk [ 15 – 23 ] and lower healthcare costs [ 4 – 6 ].…”