Non-steroidal anti-inflammatory drugs for sciatica

Abstract

This updated systematic review including 10 trials evaluating the efficacy of NSAIDs versus placebo or other drugs in people with sciatica reports low- to very low-level evidence using the GRADE criteria. The efficacy of NSAIDs for pain reduction was not significant. NSAIDs showed a better global improvement compared to placebo. These findings must be interpreted with caution, as the level of evidence according to the GRADE classification was very low for the outcome pain reduction and low for global improvement due to small study samples, inconsistent results, imprecision, and a high risk of bias in the included trials. While the trials included in the analysis were not powered to detect potential rare side effects, we found an increased risk for side effects in the short-term NSAIDs use. As NSAIDs are frequently prescribed, the risk-benefit ratio of prescribing the drug needs to be considered.

Current and future pharmacological agents for the treatment of back pain

“…There appears to be no difference in analgesic efficacy between different NSAIDs, or between COX-2 selective versus nonselective NSAIDs. There is mixed evidence for the use of NSAIDs in pain conditions with a predominantly neuropathic component including lumbosacral radicular pain, though these medications are often used to treat these conditions [19,20]. A Cochrane review evaluating NSAIDs for sciatica based on predominantly low-quality studies found non-significant differences between NSAIDs and placebo for pain relief, though NSAIDs were superior for global improvement [20].…”

Radicular Pain Syndromes: Cervical, Lumbar, and Spinal Stenosis

“…management, large-scale clinical trials for radicular syndromes are variable. 21 Though dramatic benefit from NSAIDs is rare, patients may report some benefit. This matches the mild global improvement seen in a Cochrane meta-analysis.…”

“…This matches the mild global improvement seen in a Cochrane meta-analysis. 21 Short course of NSAIDs can be helpful in acute and subacute radicular pain, guarding for adverse drug reactions. In a similar fashion, shortcourse corticosteroids have mild to moderate benefit for acute and subacute radicular pain.…”

Diagnostics, treatment, rehabilitation and prevention of vertebral syndromes caused by traumatic elements

“…Біль є найчастішою скаргою хворих з патологією опорнорухового апарату й однією з найчастіших причин звернення по лікарську допомогу, втрати працездатності та вживання нестероїдних протизапальних препаратів (НПЗП). М'язовоскелетний біль досить часто є резистентним до лікування НПЗП [8]. Рентгенологічні, магнітно-резонансні (МРТ) та інші методи візуальної діагностики, за даними літератури, не завжди корелюють зі ступенем клінічних проявів [1,2].…”