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Evidence summaries

Non-Steroidal Anti-Inflammatory Drugs (Nsaids) in Acute Low Back Pain

Non-steroidal anti-inflammatory drugs (NSAIDs) are effective for patients with acute and chronic low-back pain without sciatica, although the effects are small. For patients with sciatica, there is no evidence that NSAIDs are more effective than placebo. Level of evidence: "A"

A Cochrane review 2 (abstract , review [Abstract]) included 65 studies with a total of 11 237 subjects. In the studies that reported on non-sciatic/mixed acute low-back pain, the pooled WMD was -8.39 (95% CI -12.68 to -4.10), indicating a statistically significant effect in favour of NSAIDs compared to placebo. In the sciatica-only studies there was no statistical difference in effect between NSAIDs and placebo (WMD -0.16; 95% CI -11.92 to 11.52). The pooled RR for side effects was 1.35 (95% CI 1.09 to 1.68), indicating statistically significantly fewer side effects in the placebo group. In the four studies which compared NSAIDs with placebo for chronic low-back pain the pooled WMD was -12.40 (95% CI -15.53 to -9.26), indicating a statistically significant effect in favour of NSAIDs compared to placebo. The pooled RR for side effects was 1.24 (95% CI 1.07 to 1.43), indicating statistically significantly fewer side effects in the placebo group.

    References

    • Roelofs PD, Deyo RA, Koes BW, Scholten RJ, van Tulder MW. Non-steroidal anti-inflammatory drugs for low back pain. Cochrane Database Syst Rev 2008 Jan 23;(1):CD000396. [PubMed]

Primary/Secondary Keywords