NSAID’s for Acute Low Back Pain, Not Clinically Relevant?

Non-Steroidal anti-inflammatory drugs (NSAID) are one of the most commonly used over the counter medications to treat or manage pain. We often recommend taking an NSAID over a Tylenol for acute back pain as it has shown to be more effective. According to recent research NSAID’s may not be as effective for acute back pain, as we thought.

This new study was a review of literature on the use of NSAID’s for acute low back pain compared to placebo or alternative treatments. They identified 32 studies with a total of 5356 participants. The authors found that there is moderate quality evidence that NSAIDs are slightly more effective in short‐term reduction of pain intensity than placebo. They also found that there is high quality evidence that NSAID’s are slightly more effective in reducing disability in the short-term than placebo. The authors found that there is very low quality evidence of no clear difference between the proportion of participants who could return to work after seven days between those who used NSAIDs and those who used placebo.

If you are wondering the authors of this study were grading the quality of the studies they were looking into. This is done based on the criteria of the authors. Grade’s of evidence indicate to us about how strong the study is. The results of a high quality study would mean more than the results of a low quality study. The thing to note in this study is despite the quality of the study the authors were finding that NSAID’s could barely do better than a placebo. Not exactly a good thing when trying to decide if an NSAID is worth taking.

In the end the authors of this study determined that “NSAIDs seemed slightly more effective than placebo for short‐term pain reduction, disability, and global improvement, but the magnitude of the effects is small and probably not clinically relevant.” This means that the level of relief provided by NSAID’s is so small the patient might not notice much different between taking an NSAID or not.

What does this Mean?

Should you not take an NSAID for acute back pain? Should you take anything for acute back pain?

I think the takeaway from this study is we should not rely on an OTC drug like an NSAID to be the thing we use to treat our back pain. If you have acute back pain you need to be treated properly. In our case that involves adjusting the appropriate vertebra to restore normal joint integrity thus reducing and eventually eliminating the pain. During that process taking an NSAID may help to “take the edge off” of the pain. Taking an NSAID should not be the sole form or treatment for back pain.

If you have any low back pain or are prone to flare-ups of low back pain it is prudent you get that checked out by a Chiropractor. Call us for a complimentary consultation today. 630-232-6616