How effective are non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of non-specific low-back pain?
Only 42% of the studies were considered to be of high quality, and many of them had small numbers of participants. Placebo and paracetamol/acetaminophen had fewer side effects than NSAIDs, although NSAIDS had fewer side effects than muscle relaxants and narcotic analgesics. The new COX-2 NSAIDs did not seem to be any more effective than traditional NSAIDs, but were associated with fewer side effects, particularly gastric ulcers. However, other literature has shown that some COX-2 NSAIDs are associated with increased cardiovascular risk.
NSAIDs are the most frequently prescribed medications worldwide and are widely used for patients with low-back pain. In most international guidelines for the management of low-back pain in primary care, NSAIDs are recommended as a treatment option after paracetamol/acetaminophen has been tried.