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NSAIDs for Chronic Low Back Pain: True or False?

NSAIDs for Chronic Low Back Pain: True or False?


  • ~ 50 studies show that NSAIDs are beneficial for treatment of chronic low back pain (CLBP).

  • False. A recent literature review found only 14 RCTs (1982-2013) examining the use of NSAIDs for CLBP.

  • There is no literature that indicates opioids are more effective for CLPB than NSAIDS.

  • True. Opioids are often assumed to be the most effective analgesics, but there is no evidence that they are more effective than NSAIDs for CLBP.

  • When NSAIDs are compared to placebo for CLBP, the former are associated with greater reduction in pain that is statistically significant.

  • True. Studies have shown NSAIDs to be more effective than placebo for CLBP relief; but after correction for study bias, the difference was not statistically significant.

  • NSAIDs are associated with greater improvement in functioning vs placebo.

  • False. There is little research on NSAID impact on functional level in CLBP; where NSAIDs have shown greater benefit vs placebo, quality of evidence is considered low.

  • There are factors that help predict likely patient benefit from NSAID treatment of CLBP.

  • False. Currently there is no way to predict benefit of NSAID treatment for CLBP.

  • There are clear differences demonstrated among NSAIDs in terms of treatment efficacy for CLBP.

  • False. Evidence is insufficient to determine whether one NSAID is more effective than another for CLBP.

  • There are no predictive factors for determining which NSAID will be most effective for a patient with CLBP other than previous positive response to a specific agent.

  • True. No predictive factors have been identified that would indicate which NSAID is likely to be most beneficial for an individual patient.

  • The optimal duration of NSAID treatment for CLBP has yet to be established.

  • True. Recommendations are that NSAID use for CLBP be limited to the shortest duration possible, but no optimal duration is known.

  • NSAIDS have proven more effective for management of CLBP than acetaminophen.

  • False. Studies that compare efficacy of NSAIDs vs APAP for CLBP are few and the findings do not support the superiority of NSAIDs over acetaminophen.

  • It has yet to be established whether combining an NSAID with an analgesic from another class is likely to provide more benefit for CLBP management than the NSAID alone.

  • True.There is limited research on the efficacy of combining analgesics from different classes to manage chronic pain of any type.

Guidelines for treatment of chronic low back pain (CLBP) recommend remaining active and exercising, with the use of analgesics if necessary. Nonsteroidal anti-inflammatory drugs (NSAIDs), both over the counter and by prescription, are one of the most frequently used agents in low back pain management.

How effective are they?

Try these 10 True or False statements based on a recent update to a Cochrane review of NSAID use for chronic back pain. The truths may surprise you.   

Comments

moderately

Kelly @

very

Lynn @

Margot

Cherise @

True

Sharon @

True

Stephanus @

Useful info. Opioids are obviously going to address pain more effectively but patients with clbp often have many other conditions including depression -
The addiction dependency tolerance issues are too high an opioid tx.

Anonymous @

NSAIDS work for my CLBP, however the NSAIDS are killing my kidney functioning.

Linda @

true

farouq @

false

farouq @

false

farouq @

true

farouq @

False

OLUSOLA A. @

True

OLUSOLA A. @

false

Joe @

true

yelena @

true

dianne @

A EXTRA STRENGTH TYLENOL AND AN IBUPROFEN 800MG OR A NAPRASYN AT THE SAME TIME HAS WORKED WONDERS FOR MY PATIENTS. IT HAS NOT CAUSED ANY MAJOR SIDE EFFECTS ALSO.

julian @

false

farouq @

IDK about that one hoss.

Joseph @

Jan

jan @

Having taken nsaids for years I have no doubt they help my pain. I believe a large problem is the multiple problems that cause low back pain. Any good study must differentiate the causes before outcomes can be assessed.

Dean @

true

farouq @

true

farouq @

true

farouq @

true

farouq @

true

farouq @

true

farouq @

true

farouq @

true

farouq @

They are effective but has complications specially in patients with renal disease and ulcers. Even if they have normal renal function , monitoring closely is needed.

Anonymous @

true

Anonymous @

Hurm

John B @

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