Reaching for an anti-inflammatory is one of the most common first responses to back or neck pain. They are easy to find, familiar, and often take the edge off. But how much do they really help with spinal pain, and are they the right longer-term answer? A large review of the research suggests they help far less than most people assume.
What the study found
A 2017 review set out to test how well anti-inflammatories (NSAIDs) work for spinal pain. It reviewed 5,208 individual records and narrowed them down to 35 randomised trials, covering a range of spinal pain types:
- 11 trials on chronic back pain
- 11 trials on acute back pain
- 11 trials on sciatica
- 4 trials on neck pain
The conclusion was clear: while anti-inflammatories can be effective, their benefit is clinically insignificant compared with a placebo. The authors highlighted an urgent need to develop better pain relief strategies.
"We provide sound evidence that NSAIDs are effective, but do not offer clinically important benefits for spinal pain above those attributable to placebo."
Machado et al. (2017)
Why anti-inflammatories alone are not enough
These findings point to a deeper issue in how spinal pain is treated. Pain, and spinal pain in particular, is rarely a simple mechanical problem that one tablet can fix. Pain is multifaceted: it involves biological, psychological and social factors at the same time. This understanding is reflected in Williams and Craig's work on updating the definition of pain, which stresses the psychosocial side of the experience, not just the physical.
There is a second problem. Spinal pain is often grouped together as a single condition, when in reality it has many different causes and contributing factors. Averaging all of those cases together makes it hard to see how well any one treatment really works for any one person.
A more complete approach to spinal pain
The idea of a single "magic bullet" for pain is, unfortunately, a flawed one. As covered in a related article on noninvasive management of low back pain, there is strong evidence behind combined approaches to pain management.
This is not an argument against medication. Anti-inflammatories have their place, and for some people and some episodes they are a useful tool. They also carry potential side effects and are not suitable for everyone, which is another reason they are better seen as one option rather than the whole answer. Pain is too complex to be managed well by anti-inflammatories alone.
A more complete approach combines treatments that each target a different part of the problem: hands-on chiropractic care for the mechanical and functional side, movement and graded activity, attention to sleep and stress, which strongly influence pain, and medication where it is appropriate. Used together, these usually produce far better results than any one of them alone.
If you are dealing with spinal pain
If spinal pain is ongoing, it helps to work with someone who looks at the whole picture rather than relying on a single quick fix. A practitioner who can assess the mechanical drivers, guide the right movement, and coordinate care with other professionals where needed will usually get further than medication alone.
Learn more about how chiropractic care approaches pain, or book a visit to talk through what is driving your pain and the options for managing it.
Common questions
Should I stop taking anti-inflammatories for my back pain?
No article can answer that for you. Anti-inflammatories can help in the short term, but whether to start, continue or stop any medication is a decision to make with the doctor or pharmacist who recommended it. Never change prescribed medication based on general information alone.
If anti-inflammatories do not help much, what does?
The research points away from any single treatment and towards a combination: addressing the mechanical and functional side of the spine, staying active in a graded way, looking after sleep and stress, and using medication only where it helps. The right mix depends on the person and the cause of their pain.
Can chiropractic care help with spinal pain?
Chiropractic care can play a useful role in managing the mechanical and functional aspects of back, neck and sciatic pain, especially as part of a broader, multidisciplinary plan. A proper assessment is the best way to know whether it is appropriate for your situation.
