Patients with chronic low back pain frequently use non-steroidal anti-inflammatory drugs (NSAIDs), but their overall efficacy remains unclear.
Researchers surveyed 13 trials, conducted between 1981 and 2011, to find out whether NSAIDs are associated with greater pain relief than placebo, other drugs and non-drug treatments for patients with chronic lower back pain.
Of the six studies that compared NSAIDs with placebo, NSAIDs were associated with a statistically significant improvement in pain intensity and disability. However, the magnitude of the association was small, and the evidence quality was low.
In one study comparing celecoxib with tramadol, celecoxib was associated with a better overall improvement in pain from baseline. In another study comparing NSAIDs to home-based exercise, disability improved more in patients who exercised but with no difference in pain scores.
Future research is needed to identify patients most likely to respond well to NSAIDs, the researchers conclude in the Journal of the American Medical Association
(13 June 2017).