scholarly journals Prevention and Treatment of Back Pain: Experts’ Consensus Recommendations

Doctor Ru ◽  
2020 ◽  
Vol 19 (9) ◽  
pp. 45-52
Author(s):  
A.L. Vertkin ◽  
◽  
M.M. Shamuilova ◽  
G.Yu. Knorring ◽  
Yu.V. Sedyakina ◽  
...  
Keyword(s):  
Back Pain ◽  
General Practitioners ◽  
Optimal Treatment ◽  
Prolonged Action ◽  
Consensus Recommendations ◽  
Psychological Tools ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Fast Acting ◽  
Action Structure

Objective of the Review: To present, for internists and general practitioners, two sets of multidisciplinary consensus recommendations for the management of patients with back pain. Key Points: The paper includes short diagnostic protocols, red flag screening protocols, and criteria for involving specialists from related fields, starting physiotherapy, and using a battery of psychological tools. Also covered are criteria for optimal treatment with medications, including fast-acting analgesics (particularly non-steroidal anti-inflammatory drugs) and prolonged-action structure-modifying drugs. Conclusion: The management of patients with non-specific back pain is dealt with by internists or general practitioners. It requires a clear, structured approach to identifying red flags and bringing in specialists from related fields; lifestyle and diet modifications; exercise and physical therapy; a battery of psychological tools; and, without question, optimal treatment with medications, including fast-acting analgesics and prolonged-action structure-modifying drugs. Keywords: non-steroidal anti-inflammatory drugs, back pain, treatment protocol, neurotropic B vitamins, prolonged-action structuremodifying drugs.

scholarly journals Efficacy and safety of different nonsteroidal anti-inflammatory drugs for acute neck and back pain

2020 ◽  
Vol 12 (2) ◽  
pp. 42-47
Author(s):  
E. Yu. Plotnikova ◽  
V. N. Zolotukhina ◽  
L. K. Isakov ◽  
M. N. Sinkova ◽  
M. A. Sinkov
Keyword(s):  
Back Pain ◽  
Efficacy And Safety ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Efficacy and Safety of Duloxetine in Patients with Chronic Low Back Pain Who Used versus Did Not Use Concomitant Nonsteroidal Anti-Inflammatory Drugs or Acetaminophen: A Post Hoc Pooled Analysis of 2 Randomized, Placebo-Controlled Trials

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Vladimir Skljarevski ◽  
Peng Liu ◽  
Shuyu Zhang ◽  
Jonna Ahl ◽  
James M. Martinez
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Pooled Analysis ◽  
Analysis Of Covariance ◽  
Low Back ◽  
Substantial Evidence ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Post Hoc

This subgroup analysis assessed the efficacy of duloxetine in patients with chronic low back pain (CLBP) who did or did not use concomitant nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen (APAP). Data were pooled from two 13-week randomized trials in patients with CLBP who were stratified according to NSAID/APAP use at baseline: duloxetine NSAID/APAP user (), placebo NSAID/APAP user (), duloxetine NSAID/APAP nonuser (), and placebo NSAID/APAP nonuser (). NSAID/APAP users were those patients who took NSAID/APAP for at least 14 days per month during 3 months prior to study entry. An analysis of covariance model that included therapy, study, baseline NSAID/APAP use (yes/no), and therapy-by-NSAID/APAP subgroup interaction was used to assess the efficacy. The treatment-by-NSAID/APAP use interaction was not statistically significant () suggesting no substantial evidence of differential efficacy for duloxetine over placebo on pain reduction or improvement in physical function between concomitant NSAID/APAP users and non-users.

scholarly journals Repeated short cycles of nonsteroidal anti-inflammatory drugs and kidney injury in patients with spinal degenerative-dystrophic diseases

2018 ◽  
Vol 12 (3) ◽  
pp. 94-97
Author(s):  
D. M. Bichurina ◽  
I. Z. Gaydukova ◽  
D. А. Patrikeeva ◽  
A. P. Rebrov
Keyword(s):  
Back Pain ◽  
Kidney Injury ◽  
Control Group ◽  
Study Group ◽  
Creatinine Ratio ◽  
Healthy Individuals ◽  
Group A ◽  
Inflammatory Drugs ◽  
The Mean ◽  
Anti Inflammatory

Objective: to evaluate kidney function in patients with spinal degenerative-dystrophic diseases (SDDDs) who take nonsteroidal anti-inflammatory drugs (NSAIDs) as repeated short cycles of treatment for severe back pain.Patients and methods. The investigation enrolled 97 patients with SDDDs who took NSAIDs for back pain (a study group). A control group consisted of sexand age-matched healthy individuals who had not used NSAIDs within the past year (n=40). Glomerular filtration rate (GFR) was estimated using the CKD-EPI equation and markers of kidney injury (albuminuria and globulinuria) were measured.Results. In the study group, GFR was decreased to <90 ml/min/1.73 m2 in 61 (62.9%) patients, to <60 ml/min/1.73 m2 in 11 (11.3%); the mean GFR was 77.5 [68.0; 89.0] ml/min/1.73 m2; in the control group, a decline in GFR to 89–60 ml/min/1.73 m2 was recorded in 35 (62.5%) cases; this indicator was >90 ml/min/1.73 m2 in the remaining 15 (37.5%) cases; the mean GFR was 82.5 [70.8; 90.0] ml/min/1.73 m2 (p≥0.05 for all pairwise comparisons). A decrease in GFR to <60 ml/min/1.73 m2 was found in 11 (11.3%) patients in the study group and in nobody in the control group (p=0.026). Elevated albuminuria was noted in 74 (76.3%) patients with SDDDs and in 9 (22.5%) healthy individuals (p<0.05). Albumin/creatinine ratio was 57.1 [33.8; 82.4] mg/g in the study group and 25.0 [17.5; 32.9] mg/g in the control group (p<0.0001). Increased globulinuria was established in all the patients with SDDDs and only in 3 (7.5%) healthy examinees. Globulin/creatinine ratio was 134.7 [77.5; 197.7] mg/g in the study group and 12.9 [0.5; 18.1] mg/g in the control group (p<0.0001).Conclusion. A decline in GFR to <60 ml/min/1.73 m2 was more often seen in the patients taking NSAIDs for spine pain caused by SDDDs than in the healthy individuals. In case of comparable GFR, the level of kidney injury markers was significantly higher in the study group than that in the control group, which suggests that patients with SDDDs who take NSAIDs have subclinical tubulointerstitial and glomerular changes.

Prescriber responsibility, predictors for initiation, and 20-year trends in use of non-aspirin non-steroidal anti-inflammatory drugs in patients with cardiovascular contraindications: a nationwide cohort study

2020 ◽  
Author(s):  
Morten Schmidt ◽  
Anton Pottegård
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
General Practitioners ◽  
Treatment Duration ◽  
St Segment Elevation ◽  
Disease Subtype ◽  
St Segment ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
One Year

Abstract Aims To examine whether prescription patterns complied with recommendations not to use non-steroidal anti-inflammatory drugs (NSAIDs) in patients with cardiovascular contraindications. Moreover, we examined predictors for initiation and prescriber responsibility. Methods and results We used Danish medical databases to identify all patients with first-time cardiovascular disease during 1996–2017 (n = 628 834). We assessed standardized prevalence proportions, predictors from logistic regression, and prescriber identifiers. One-year prevalence of NSAID initiation increased 3.4% from 1996 (19.4%) to 2001 (22.7%) and declined by 2.7% thereafter until 2017 (13.5%). Trends were independent of age, sex, and disease subtype, although larger annual declines occurred for heart failure (3.9%) and ischaemic heart disease (3.5%) since 2002. One-year prevalence remained highest among patients with venous thromboembolism (16.6%) and angina (13.8%), and lowest for ST-segment elevation myocardial infarction (7.0%) and heart failure (8.8%). Initiators were predominantly prescribed ibuprofen (59%), diclofenac (23%), and etodolac (6%). Diclofenac and coxib use declined, while ibuprofen and naproxen use increased. Median prescribed pill dose of ibuprofen declined after 2008 from moderate/high (600 mg) to low (400 mg). Treatment duration declined for all NSAIDs, except celecoxib. Rheumatic, obesity, and pain-related conditions predicted NSAID initiation. General practitioners issued 86–91% of all NSAID prescriptions, followed by hospital prescribers (7.3–12%). Conclusions Initiation of NSAIDs in patients with cardiovascular disease declined since 2002. Shorter treatment duration, declining COX-2 inhibition, and increasing use of naproxen and low-dose ibuprofen suggest adherence to guidelines when NSAIDs cannot be avoided. Still, NSAID use remained prevalent despite cardiovascular contraindications, warranting awareness of appropriateness of use among general practitioners in particular.

Non-steroidal anti-inflammatory drugs for low back pain

2008 ◽  
Author(s):  
Pepijn DDM Roelofs ◽  
Rick A Deyo ◽  
Bart W Koes ◽  
Rob JPM Scholten ◽  
Maurits W van Tulder
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
Inflammatory Drugs ◽  
Anti Inflammatory
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