Study: NSAIDs May Not be Best Option for Treating Spinal Pain

Non-steroidal anti-inflammatory drugs (NSAIDs) provide little relief in patients with spinal pain and increase the risk for gastrointestinal side effects, according to a new study.

Previous research has shown that paracetamol is ineffective at relieving spinal pain, but the effectiveness of NSAIDs for spinal pain is less well understood.
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Researchers conducted a meta-analysis including 35 randomized controlled trials that compared NSAIDs to placebo for treating spinal pain in participants. The median duration of the trials was 7 days. Researchers assessed risks for bias and quality of evidence, and used a between-group difference of 10 points on a scale of 0-100 for pain and disability as the smallest worthwhile effect.

Their findings showed that NSAIDs reduced pain and disability, but the effects were clinically unimportant over the placebo.

“Six participants (95% CI 4 to 10) needed to be treated with NSAIDs, rather than placebo, for one additional participant to achieve clinically important pain reduction,” the researchers wrote.

For different types of spinal pain, only 3 out of 14 analyses showed pooled treatment effects marginally above the study threshold for clinical importance.

In addition, patients taking NSAIDs had a 2.5 times higher risk for gastrointestinal reactions.

“At present, there are no simple analgesics that provide clinically important effects for spinal pain over placebo. There is an urgent need to develop new drug therapies for this condition,” the researchers concluded.

—Melissa Weiss

Reference:

Machado GC, Maher CG, Ferreira PH, et al. Non-steroidal anti-inflammatory drugs for spinal pain: a systematic review and meta-analysis [published online February 2, 2017]. Annals of the Rheumatic Diseases. doi: http://dx.doi.org/10.1136/annrheumdis-2016-210597.