Australians suffering from back pain are wasting billions on pain relief drugs that might actually be causing more harm than good, according to a new study.
In a comprehensive review published in the scientific journal, Annals of the Rheumatic Diseases, researchers from the George Institute of Global Health in Sydney found that commonly prescribed non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin, provide little to no benefit in treating back pain.
“Back pain is the leading cause of disability worldwide and is commonly managed by prescribing medicines such as anti-inflammatories,” lead author Associate Professor Manuela Ferreira said.
Back pain is estimated to affect around 80 per cent of Australians at least once in their lifetime.
The researchers reviewed 35 clinical trials involving over 6000 patients and found that NSAIDs provided “very limited short term pain relief” and that only one in six patients treated with these drugs achieved any significant reduction in back pain.
“They do reduce the level of pain, but only very slightly, and arguably not of any clinical significance,” Assoc Prof Ferreira said.
The team also found that patients taking NSAIDs to treat their back pain were 2.5 times more likely to suffer from gastro-intestinal problems such as stomach ulcers and bleeding.
“When you factor in the side effects which are very common, it becomes clear that these drugs are not the answer to providing pain relief to the many millions of Australians who suffer from this debilitating condition every year.”
NSAIDs work by inhibiting the actions of enzymes called cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), which produce chemicals that cause pain and inflammation.
Clinical guidelines currently recommend NSAIDs as the second line painkillers in between paracetamol and opioids, however, the efficacy of these drugs in treating back pain have also been called into question.
For instance, a 2015 review of research found that paracetamol is “ineffective in the treatment of low back pain and provides minimal short term benefit for people with osteoarthritis”.
Opioids have been found to provide little benefit when compared to a placebo, not to mention that it is also highly addictive and that opiate use in Australia had increased fourfold over the last decade.
Dr Brad McKay, a Sydney-based doctor and host of Embarrassing Bodies Down Under, says there needs to be a shift in the treatment and prevention of back pain.
“This latest research calls for a reassessment of our clinical guidelines, but unfortunately we don’t have many great solutions for people living with chronic low back pain,” Dr McKay told The New Daily.
“We need a new paradigm of thinking about back pain, not only looking for new drugs, but also considering other physical treatments or therapies.”
Research has shown that exercise, either alone or coupled with education, was an effective tool for preventing low back pain, whereas education alone, back belts and shoe insoles provided no benefit.
“Many people don’t even think about taking care of their back until it’s too late,” Dr McKay said.
“Prevention is the best cure.”
The main takeaways
- Commonly prescribed painkillers called non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin, provide little to no benefit in treating back pain.
- Patients who regularly take these drugs for their back pain had a significant risk of developing gastrointestinal problems such as stomach ulcers and bleeding.
- Exercise may be the best cure.