Anti inflammatory drugs and back pain
Recent research has shown that ibuprofen and other anti inflammatory drugs have little effect on reducing low back pain.
In the past, as a chiropractor I have often advised patients with low back pain that as well as receiving chiropractic treatment it is beneficial to them to take an anti inflammatory drug to help relieve the pain. I took them myself when I had a bout of back pain! I think that most of us in pain want to take something to try to help us to feel better and if we are told that we have inflammation, it seems to make perfect sense to take an anti inflammatory drug,
However, this research led by Associate Professor Manuela Ferreira from the George Institute for Global Health in Australia published recently in the journal Annals of the Rheumatic Diseases, found while the drugs offered little to no benefit, patients taking them were 2.5 times more likely to suffer from gastrointestinal problems such a stomach ulcers and bleeding.
She also said that anti inflammatory drugs were commonly used for low back pain but that in reality they are not much more effective than placebo – i.e. taking a sugar pill.
Researchers analysed 35 peer-reviewed trials on the use of nonsteroidal anti-inflammatory drugs [NSAIDs] such as ibuprofen for back pain, reviewing data from 6,065 patients.
They found that none of the painkillers did anything for the back pain other than offering mild relief and that the small effect obtained was really not big enough to be considered clinically important.
She said that therefore in her opinion, guidelines should be updated to reflect the drugs had little benefit.
It seems that we are wasting our money on these drugs and also run the risk of further harm to our body – all for very little pain relief.
“These drugs are effective for other conditions but for people with back pain, we believe there is a bigger role for other treatments,” she said.
“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.”
Professor Chris Del Mar, an evidence-based medicine specialist and professor of public health at Bond University in Queensland, Australia, said both doctors and patients tended to believe medicines for back pain were more effective than the evidence shows.
As chiropractors, we want to advise you the best and most effective way to help to relieve your back pain as quickly as possible but armed with this recent evidence, you can understand that we will no longer be advising our patients to take anti inflammatories. After treatment it will be better to use an ice pack for short periods and also to keep moving gently and without irritating the problem and just put on a brave face. Your back pain WILL go away, particularly if you have treatment quickly and like any injury, it does take time to heal – whether you are dealing with a sprain, strain or broken bone.
Where chiropractors help is that we get the joint that is affected working as it should and advise you how to avoid movements that will make things worse. When a joint is moving as well as it should, then the tissues that are inflamed around the joint – ligaments, muscles, joint capsule or disc, can move without being under stress that just perpetuates the inflammation. Without the irritation, the tissues can recover and then we can show you how to move or lift or play your sport without irritating the tissues again. If you are moving in the wrong way, it is only a matter of time before you create that painful inflammation. Chiropractors will show you exercises too that will strengthen the muscles around the affected area to try to prevent recurrence.
These things take time, and when you are in pain, you want it gone NOW and we understand that. However, it is silly to take medication that does not help much and can give you stomach problems.
It is better to take natural remedies such as ginger or turmeric that are natural anti inflammatories and won’t do you any harm.