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European Spine Journal
Published in: European Spine Journal 1/2016

01-01-2016 | Review Article

Are non-steroidal anti-inflammatory drugs effective for the management of neck pain and associated disorders, whiplash-associated disorders, or non-specific low back pain? A systematic review of systematic reviews by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration

Authors: Jessica J. Wong, Pierre Côté, Arthur Ameis, Sharanya Varatharajan, Thepikaa Varatharajan, Heather M. Shearer, Robert J. Brison, Deborah Sutton, Kristi Randhawa, Hainan Yu, Danielle Southerst, Rachel Goldgrub, Silvano Mior, Maja Stupar, Linda J. Carroll, Anne Taylor-Vaisey

Published in: European Spine Journal | Issue 1/2016

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Abstract

Purpose

To evaluate the effectiveness of non-steroidal anti-inflammatory drugs (NSAIDs) for the management of neck pain and associated disorders (NAD), whiplash-associated disorders, and non-specific low back pain (LBP) with or without radiculopathy.

Methods

We systematically searched six databases from 2000 to 2014. Random pairs of independent reviewers critically appraised eligible systematic reviews using the Scottish Intercollegiate Guidelines Network criteria. We included systematic reviews with a low risk of bias in our best evidence synthesis.

Results

We screened 706 citations and 14 systematic reviews were eligible for critical appraisal. Eight systematic reviews had a low risk of bias. For recent-onset NAD, evidence suggests that intramuscular NSAIDs lead to similar outcomes as combined manipulation and soft tissue therapy. For NAD (duration not specified), oral NSAIDs may be more effective than placebo. For recent-onset LBP, evidence suggests that: (1) oral NSAIDs lead to similar outcomes to placebo or a muscle relaxant; and (2) oral NSAIDs with bed rest lead to similar outcomes as placebo with bed rest. For persistent LBP, evidence suggests that: (1) oral NSAIDs are more effective than placebo; and (2) oral NSAIDs may be more effective than acetaminophen. For recent-onset LBP with radiculopathy, there is inconsistent evidence on the effectiveness of oral NSAIDs versus placebo. Finally, different oral NSAIDs lead to similar outcomes for neck and LBP with or without radiculopathy.

Conclusions

For NAD, oral NSAIDs may be more effective than placebo. Oral NSAIDs are more effective than placebo for persistent LBP, but not for recent-onset LBP. Different oral NSAIDs lead to similar outcomes for neck pain and LBP.
Appendix
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Metadata
Title
Are non-steroidal anti-inflammatory drugs effective for the management of neck pain and associated disorders, whiplash-associated disorders, or non-specific low back pain? A systematic review of systematic reviews by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration
Authors
Jessica J. Wong
Pierre Côté
Arthur Ameis
Sharanya Varatharajan
Thepikaa Varatharajan
Heather M. Shearer
Robert J. Brison
Deborah Sutton
Kristi Randhawa
Hainan Yu
Danielle Southerst
Rachel Goldgrub
Silvano Mior
Maja Stupar
Linda J. Carroll
Anne Taylor-Vaisey
Publication date
01-01-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 1/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-3891-4

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