NSAID therapy 'may offer little actual benefit for back pain'
Published on 06 February 2017
A study from the George Institute for Global Health in Sydney, Australia has indicated that commonly used non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin have little effect on remedying people's pain, while potentially putting them at risk of debilitating side effects.
Doing more harm than good?
Published in the Annals of the Rheumatic Diseases, the new study examined data from 35 existing trials, involving more than 6,000 people in total. It aimed to build on previous research showing that paracetamol is ineffective and opioids provide minimal benefit for back pain.
Most clinical guidelines currently recommend NSAIDs as the second choice for pain killers after paracetamol, with opioids coming in third. However, the new study data indicated that a mere one in six back pain patients treated with NSAIDs achieve any significant reduction in pain.
Moreover, patients taking anti-inflammatory medicines were also shown to be 2.5 times more likely to suffer from gastrointestinal problems such as stomach ulcers and bleeding, suggesting the drugs may well be doing more harm than good.
The need for a new approach
Given how prevalent a problem back pain is, these findings highlight the urgent need for new therapies that are more effective in providing tangible relief.
The report also called for a stronger focus on preventing back pain from developing, with interventions such as education and exercise programmes known to substantially reduce a person's risk of developing the condition.
Associate professor Manuela Ferreira of the George Institute for Global Health, who led the study, said: "Back pain is the leading cause of disability worldwide and is commonly managed by prescribing medicines such as anti-inflammatories. But our results show anti-inflammatory drugs actually only provide very limited short-term pain relief. They do reduce the level of pain, but only very slightly, and arguably not of any clinical significance."
Arthritis Research UK's view
Professor Phil Conaghan from Leeds University, an Arthritis Research UK spokesperson, said: "Back pain affects one-third of the UK population and can have a devastating impact on a person's everyday life. We know a large number of people with back pain rely on medication to help manage their pain. This review of existing back pain research highlights how relatively few studies have been done on NSAID use for this huge problem.
"This work highlights what we have learnt for many joint pain problems: staying strong and keeping moving remain critical. However, we should be cautious about applying this message to all back pain problems, as there may be some groups who do get effective pain relief. There is clearly a need for well-designed research for the commonest joint pain problem."
For examples of exercises designed to reduce the impact of back pain, please visit www.arthritisresearchuk.org/backexercises