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Spinal Pain Drugs Don't Work

April 5, 2019

That's what researchers at the George Institute in Sydney have found over the past couple of years. Back pain researchers have been discovering a common theme to the medications that our patients often take for their spinal pain:

  • the benefits are overstated and the side-effects are under-reported or played down.

This patient handout is a summary and the references of 5 recent papers (see references below) that show the drugs our patients are taking are no better than placebo or such a small improvement (<10 points/100) BUT the side-effects are dangerous, particularly NSAIDs which increase the risk of a heart attack by up to 58%!


Remember NSAIDs/cortisone and PBM don't go together. It's like a tug-of-war. One's a blocker and the other (photobiomodulation) a resolver and energiser.

 

These anti-inflammatory drugs block biochemical pathways whereas photobiomodulation assists in the resolution of the natural inflammatory process. The natural process of acute inflammation in the body needs to be assisted so that it resolves and doesn't get stuck and become chronic inflammation.

 

So, give this handout to your patient to take to their GP for further discussion. 

And finally, listen to a good audio summary by Dr Norman Swan from the Health Report on the ABC. (27 March 2017).

 

References:

1. Machado GC et al , Efficacy and safety of paracetamol for spinal pain and osteoarthritis:systematic review and meta-analysis of randomised placebo controlled trials. BMJ 2015; 350. PMID: 25828856

2. Machado GC, Maher CG, Ferreira PH, et al Non-steroidal anti-inflammatory drugs for spinal pain:systematic review and meta-analysis. Ann. Rheumatic Dis. 2017 Jul;76(7):1269-1278. PMID: 28153830

3. Bally et al. Risk of acute myocardial infarction with NSAIDs in real world use:bayesian meta-analysis of individual patient data. BMJ May 2017;357:j1909 PMID: 28487435.

4. Shaheed C et al, Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back PainA Systematic Review and Meta-analysis. JAMA Intern Med. 2016;176(7):958-968. PMID: 27213267.

5. Mathieson S, (Chiro) et al Trial of Pregabalin for Acute and Chronic Sciatica.N Engl J Med. 2017 Mar 23;376(12):1111-1120 PMID 28328324

 

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