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NSAIDs No Better for Low Back Pain

Acetaminophen provides comparable relief, researchers say

WEDNESDAY, Jan. 23 (HealthDay News) -- When it comes to treating low back pain, non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen and ibuprofen are no more effective than acetaminophen.

That's the conclusion of researchers who reviewed more than 65 studies that included more than 11,000 people with low back pain.

The review authors concluded that NSAIDs are "slightly effective" for short-term symptomatic relief in patients with acute and chronic low back pain without sciatica. But they said it's unclear whether NSAIDs work better than simple analgesics or other drugs. No kind of NSAID was obviously better than another.

NSAIDs were not superior to acetaminophen, the researchers said.

The researchers said the review data "support guidelines for the management of low back pain in primary care that recommend NSAIDs as a treatment option after (acetaminophen) has been tried, since there are fewer side effects with (acetaminophen)," said lead reviewer Pepijn Roelofs, a doctoral student at Erasmus University Medical Center in Rotterdam, the Netherlands.

Roelofs and colleagues noted there's "conflicting evidence that NSAIDs are more effective than simple analgesics and bed rest, and moderate evidence that NSAIDs are not more effective than other drugs, physiotherapy or spinal manipulation for low back pain."

The review was published in the current issue of the journal The Cochrane Library.

"Currently, the long-term use of NSAIDs is controversial because of cardiovascular adverse effects in patients with cardiovascular risk factors, such as previous angina pectoris, heart failure and myocardial infarction," Roelofs said.

More information

The American Academy of Family Physicians has more about low back pain.

-- Robert Preidt

SOURCES: Center for the Advancement of Health, news release, Jan. 22, 2008

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