Anti-inflammatories for Spinal Pain
Discover why anti-inflammatories may not be the best solution for spinal pain. Learn about the importance of a multidisciplinary approach to effectively manage pain.
The Limitations of Anti-Inflammatories for Spinal Pain: A Multidisciplinary Perspective
Non-steroidal anti-inflammatory drugs (NSAIDs), commonly referred to as anti-inflammatories, are often prescribed to relieve spinal pain. However, a comprehensive systematic review and meta-analysis published in the Annals of the Rheumatic Diseases (2017) by Machado GC, Maher CG, Ferreira PH, et al. questions their effectiveness.
What the Study Found About Anti-Inflammatories and Spinal Pain
The study reviewed 5,208 individual records, narrowing them down to 35 randomized trials. The trials covered various types of spinal pain:
- 11 trials on chronic back pain
- 11 trials on acute back pain
- 11 trials on sciatica
- 4 trials on neck pain
โWe provide sound evidence that NSAIDs are effective, but do not offer clinically important benefits for spinal pain above those attributable to placeboโฆโ Machado et al., 2017โ
The Real Issue: Why Anti-Inflammatories Alone May Not Work
The findings of this study reveal an underlying issue in pain management. Pain, especially spinal pain, is not a simple condition that can be resolved by anti-inflammatories alone. Pain is multifaceted, involving biological, psychological, and social factors. This concept is supported by Williams and Craigโs article on updating the definition of pain, which emphasizes the importance of acknowledging the psychosocial components of pain.
Another concern is how spinal pain is grouped together as a single problem. Spinal pain can have numerous causes and contributing factors, making it difficult to assess the true effectiveness of an intervention when only looking at broad averages across patients.
A Better Approach: Multidisciplinary Care Over Anti-Inflammatories
The idea of a โmagic bulletโ for pain relief is, unfortunately, a flawed one. As mentioned in my previous post discussing noninvasive management of lower back pain, there is solid evidence supporting the effectiveness of combined approaches to pain management.
While I am certainly not against pharmacological interventionsโthere is a time and place for everythingโpain is far too complex to be managed effectively with anti-inflammatories alone. Combining chiropractic care, physiotherapy, lifestyle modifications, and when appropriate, medication, can produce much better results.
Takeaway: Rethinking Anti-Inflammatories for Spinal Pain
This study highlights the limitations of anti-inflammatories in treating spinal pain and underscores the importance of a multidisciplinary approach. Chiropractic care can play a valuable role in addressing the mechanical and functional aspects of spinal pain, while also integrating other therapies to provide a more holistic treatment.
If youโre struggling with spinal pain and are looking for effective, evidence-based treatment, consider reaching out to a professional who understands the complexity of pain and offers a comprehensive approach to care.
Disclaimer: This blog post is for informational purposes only and is not a substitute for professional medical advice. Always consult a healthcare provider for personalized recommendations.
about Dr neil cuninghame
Mtech Chiro (DUT)ย ย lย ย PG Dip Pain Mngmnt (UCT)
Hi, Iโm Dr. Neil Cuninghame, aย Hillcrest Chiropractorย specializing in helping you move better, feel better, and live better. Whether youโre struggling with chronic pain, sports injuries, or everyday aches like headaches, back pain, or shoulder discomfort, Iโm here to guide you toward lasting relief. With over 16 years of experience, Iโve helped athletes, busy professionals, parents, and many others overcome pain and return to doing what they love. My approach combines evidence-based care, personalized treatment plans, and a deep understanding of how the body works.
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Disclaimer: This blog post is for informational purposes only and is not a substitute for professional medical advice. Always consult a healthcare provider for personalised recommendations.
ยฉ Dr Neil Cuninghame 2025