Jessica J Wong1,2,3, Pierre Côté4,5, Arthur Ameis6, Sharanya Varatharajan4,7, Thepikaa Varatharajan4,8, Heather M Shearer4,7, Robert J Brison9,10, Deborah Sutton4,7, Kristi Randhawa4,7, Hainan Yu4,7, Danielle Southerst4,11, Rachel Goldgrub5, Silvano Mior5,7, Maja Stupar4, Linda J Carroll12, Anne Taylor-Vaisey4. 1. UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada. jessica.wong@uoit.ca. 2. Undergraduate Education, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada. jessica.wong@uoit.ca. 3. Division of Graduate Studies, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada. jessica.wong@uoit.ca. 4. UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada. 5. Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe Street North, Oshawa, ON, L1H 7L7, Canada. 6. Certification Program in Insurance Medicine and Medico-legal Expertise, Faculty of Medicine, University of Montreal, N-414, Roger-Gaudry Building, 2900, Boulevard Edouard-Montpetit, Montreal, QC, H3T 1J4, Canada. 7. Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada. 8. Graduate Studies in Masters of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 5E5, Canada. 9. Kingston General Hospital, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada. 10. Department of Emergency Medicine, School of Medicine, Queen's University, Kingston, ON, Canada. 11. Rebecca MacDonald Centre for Arthritis and Autoimmune Disease, Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, 60 Murray Street, 2nd Floor (Main), Toronto, ON, M5T 3L9, Canada. 12. Injury Prevention Centre, University of Alberta, 4075 RTF, 8308 114 Street, Edmonton, T6G 2E1, AB, Canada.
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.
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.
Entities:
Keywords:
Medication; Neck pain and associated disorders; Nonspecific low back pain; Nonsteroidal anti-inflammatory drugs; Systematic review; Whiplash-associated disorders
Authors: Jaime Guzman; Eric L Hurwitz; Linda J Carroll; Scott Haldeman; Pierre Côté; Eugene J Carragee; Paul M Peloso; Gabrielle van der Velde; Lena W Holm; Sheilah Hogg-Johnson; Margareta Nordin; J David Cassidy Journal: Spine (Phila Pa 1976) Date: 2008-02-15 Impact factor: 3.468
Authors: Pierre Côté; Jessica J Wong; Deborah Sutton; Heather M Shearer; Silvano Mior; Kristi Randhawa; Arthur Ameis; Linda J Carroll; Margareta Nordin; Hainan Yu; Gail M Lindsay; Danielle Southerst; Sharanya Varatharajan; Craig Jacobs; Maja Stupar; Anne Taylor-Vaisey; Gabrielle van der Velde; Douglas P Gross; Robert J Brison; Mike Paulden; Carlo Ammendolia; J David Cassidy; Patrick Loisel; Shawn Marshall; Richard N Bohay; John Stapleton; Michel Lacerte; Murray Krahn; Roger Salhany Journal: Eur Spine J Date: 2016-03-16 Impact factor: 3.134