Non-steroidal anti-inflammatory drugs for spinal pain: a systematic review and meta-analysis

“…‐ 10 A recent Cochrane systematic review (1825 participants) found that paracetamol does not result in better outcomes compared with placebo for patients with acute LBP, and its effect on chronic LBP is uncertain 24 . Non‐steroidal anti‐inflammatory drugs are endorsed in three of the four guidelines (moderate quality evidence), 7 , 9 , 10 which is consistent with a recent systematic review demonstrating the efficacy of this class of medicine for both acute and chronic LBP 25 . However, the effect size for acute LBP is small (− 6.1 points [95% CI, − 9.5 to − 2.8] on a 0–100 scale) and some have argued that this may be too small to be clinically worthwhile 25 .…”

“…In a systematic review, Zulman et al found that pharmacologic interventions were assessed in 68.9% of the RCTs for older adults with complex health issues, whereas our results revealed that pharmacologic agents were planned for only 27.4% of the protocols. Perhaps this difference is due to the limited effectiveness of pharmacologic interventions for LBP in the literature . More important than not showing the efficacy of pharmacologic agents, the exclusion of older adults from these CTs prevent the development of knowledge regarding adverse events …”

“…Sciatica is usually treated with non-steroidal anti-inflammatory drugs, but there is a lack of consensus regarding the efficacy of these drugs [7]. As a result, some patients turn to acupuncture for which there is some evidence of efficacy in treating painful symptoms associated with sciatica [8].…”