EBM of the drug therapy for acute and chronic low back pain

Abstract

Evidence of the drug therapy for non-specific low back pain (LBP) was investigated using various meta-analyses, mainly according to the results of Cochrane Review. Non-steroidal anti-inflammatory drugs (NSAIDs) were considered effective for acute LBP, however, had no evidence for chronic LBP due to lack of valuable randomized controlled trials. Strong evidence was observed of that there was no difference of efficacy in various NSAIDs and there was moderate evidence that NSAIDs was more effective than acetaminophen. The fact that some kinds of muscle relaxants was effective than placebo, had strong evidence for acute LBP, even though the effectiveness in short term period. The results of meta-analysis showed short-term efficacy of antidepressants for acute and chronic LBP, but no difference with placebo in activity of daily life. Because of difference of drugs examined in meta-analyses and difference of drug classification such as muscle relaxants including many benzodiazepines, establishment of international drug classification for comparative data and of Japan-original meta-analyses for LBP is urgently necessary.