Back pain is an ailment most of us will suffer at some point in our lives. But while we might be tempted to reach for a pack of aspirin, new research suggests we might be better off downing a sugar pill.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as include aspirin and ibuprofen, are a common form of over-the-counter treatment for back pain. But new research suggests that any small amount of relief to be gained from them wouldn’t be considered clinically significant.
Worse still, like all drugs, NSAIDs more than double the chance of developing gastrointestinal bleeding, and might present increased chances of cardiovascular problems. Meaning sufferers of back pain are taking quite a risk for an insignificant pay-off.
To figure this out, the researchers from the George Institute for Global Health in Australia, analysed data on 6,065 patients with spinal pain covered within 35 randomised, placebo-controlled trials from peer-reviewed studies.
They found for every patient reporting a clinically significant decrease in pain after two weeks on an NSAID, another six didn’t experience a clinically significant decrease.
Unfortunately, if you think this means swapping the ibuprofen for a bottle of acetaminophen (paracetamol), a Cochrane review conducted in 2015 explored three trials covering 1,825 participants with acute back pain, concluding it was also little better than a placebo.
What about opiates, such as codeine or OxyContin? Maybe some modest short-term relief for those with chronic back pain, according to research published in JAMA Internal Medicine in 2016. But once again, unlikely to be all that significant on the recommended doses.
The scientists admit their research makes for grim news.
“When this result is taken together with those from recent reviews on paracetamol and opioids, it is now clear that the three most widely used, and guideline-recommended medicines for spinal pain do not provide clinically important effects over placebo,” they write in their paper.
Team researcher Manuela Ferreira advises in The Guardian:
“We are not arguing that no pain relief should be used, but people using these types should be aware the benefits are small and that their side effects can be harmful, and that discussing with their doctors the benefit of other treatments including exercise may be worthwhile.”
On the plus side, for the majority of people, back pain is a short term problem that sorts itself out. While nobody likes being told there are no quick fixes, suffering through a weeks or months of discomfort might simply be the best option.
For those with ongoing pain, however, knowing that drugs such as aspirin and ibuprofen don’t offer a solution will at least help avoid unnecessary risks, and maybe help put them on a better path to a less uncomfortable life.
This research was published in the Annals of the Rheumatic Diseases.