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The George Institute for Global Health has performed a systematic review of drugs used to treat back pain. Their findings, published in the Annals of the Rheumatic Diseases, shows that only one in six improve their pain with NSAID therapy.
Their previous studies have shown that acetaminophen is ineffective and opioids provide minimal benefit over placebo.
Despite the enormity of back pain as a worldwide public health problem, leading to significant disability, work loss and societal costs, most of our medical therapies are largely ineffective and only provide limited short term relief.
Their analysis of 35 trials involving more than 6000 people, also found patients taking anti-inflammatories were 2.5 times more likely to suffer from UGI symptoms and complications, including gastric ulcers and bleeding.
Although many guidelines recommend NSAIDs and analgesics as first line therapy, we clearly need to depend more on lifestyle, physical therapy and developing new approaches for such patients.