NSAIDs for Chronic Low Back Pain: True or False?

~ 50 studies show that NSAIDs

are beneficial for treatment of chronic low back pain (CLBP).

False.

A recent literature review found only 14 RCTs (1982-2013) examining the use of NSAIDs for CLBP.

There is no literature that indicates opioids

are more effective for CLPB than NSAIDS.

True.

Opioids are often assumed to be the most effective analgesics, but there is no evidence that they are more effective than NSAIDs for CLBP.

When NSAIDs are compared to placebo

for CLBP, the former are associated with greater reduction in pain that is statistically significant.

True.

Studies have shown NSAIDs to be more effective than placebo for CLBP relief; but after correction for study bias, the difference was not statistically significant.

NSAIDs are associated with greater

improvement in functioning vs placebo.

False.

There is little research on NSAID impact on functional level in CLBP; where NSAIDs have shown greater benefit vs placebo, quality of evidence is considered low.

There are factors

that help predict likely patient benefit from NSAID treatment of CLBP.

False.

Currently there is no way to predict benefit of NSAID treatment for CLBP.

There are clear differences demonstrated among NSAIDs

in terms of treatment efficacy for CLBP.

False.

Evidence is insufficient to determine whether one NSAID is more effective than another for CLBP.

There are no predictive factors

for determining which NSAID will be most effective for a patient with CLBP other than previous positive response to a specific agent.

True.

No predictive factors have been identified that would indicate which NSAID is likely to be most beneficial for an individual patient.

The optimal duration of NSAID treatment

for CLBP has yet to be established.

True.

Recommendations are that NSAID use for CLBP be limited to the shortest duration possible, but no optimal duration is known.

NSAIDS have proven more effective

for management of CLBP than acetaminophen.

False.

Studies that compare efficacy of NSAIDs vs APAP for CLBP are few and the findings do not support the superiority of NSAIDs over acetaminophen.

It has yet to be established

whether combining an NSAID with an analgesic from another class is likely to provide more benefit for CLBP management than the NSAID alone.

True.

There is limited research on the efficacy of combining analgesics from different classes to manage chronic pain of any type.