Nonsteroidal Anti-Inflammatory Drugs for Low Back Pain

Abstract

The evidence from the 65 trials included in this review suggests that NSAIDs are effective for short-term symptomatic relief in patients with acute and chronic low back pain without sciatica. However, effect sizes are small. Furthermore, there does not seem to be a specific type of NSAID, which is clearly more effective than others. The selective COX-2 inhibitors showed fewer side effects compared with traditional NSAIDs in the randomized controlled trials included in this review. However, recent studies have shown that COX-2 inhibitors are associated with increased cardiovascular risks in specific patient populations.

Molecular Basis of Intervertebral Disc Degeneration and Herniations: What Are the Important Translational Questions?

“…Conventional treatments such as nonsteroidal antiinflammatory drugs (NSAIDs) provide effective short-term back pain relief but do not alter the progression of disc degeneration [55,76]. There is conflicting evidence about the effects of NSAIDs on intervertebral disc tissues.…”

Pharmacotherapy for Chronic Low Back Pain

“…A Cochrane review of 65 randomized controlled trials found evidence that NSAIDs are effective for the management of chronic low back pain pain, but effect sizes were indicative of only a small treatment effect (Roelofs et al, 2008). The evidence presented in this Cochrane review suggested that different NSAIDs, including cyclooxygenase-2 inhibitors, show similar efficacy in patients with chronic low back pain.…”

“…Evidence from meta-analyses provide evidence that NSAIDs are moderately more effective than acetaminophen (Lee et al, 2004;Roelofs et al, 2008), and chronic low back pain guidelines also state that NSAIDs are more effective (Airaksinen et al, 2006;Chou et al, 2007). In patients with osteoarthritis, effect sizes for NSAIDs are substantially higher than with acetaminophen but nonetheless correspond to a small treatment effect (Zhang et al, 2010).…”

Some of the Pain Features at the Bottom of the Back

“…Основной механизм действия НПВП заключается в блокировании фер-мента, участвующего в синтезе меди-аторов (посредников) воспаления и боли, а также в расширении сосудов. ЦОГ-2-селективные НПВП имели меньше побочных эффектов, чем неселективные [118]. Селективные ингибиторы ЦОГ-2 (нимесулид, целекоксиб, валдекоксиб, мелоксикам, лорноксикам), обладая противовоспалитель-ной и анальгезирующей активностью, обеспечивают большую безопасность у пациентов с заболеваниями желудочно-кишечного тракта.…”