Dubai, United Arab Emirates (CNN) — Low back pain is the leading cause of many years of living with disability worldwide. Neck pain ranked fourth, according to the 2016 Global Burden of Disease Study.
Low back pain is considered “acute” when symptoms last from one to 12 weeks, and “chronic” when the pain lasts for three months or more.
People often turn to over-the-counter pain relievers, but what is the most effective treatment?
A new study published Wednesday in the Journal of Orthopedic Research attempts to find out.
The researchers read a large number of published studies and found 18 randomized clinical trials that focused on low back pain that lasted no more than 12 weeks.
The study looked at these types of analgesics: aspirin, acetaminophen (Tylenol, Paracetamol, Panadol), and nonsteroidal anti-inflammatory drugs (NSAIDs for short), and there are plenty of them.
The researchers also looked at muscle relaxants in the study, which required a prescription.
The study found that the best treatment for acute low back pain was a combination of an NSAID and a prescription muscle relaxant.
The combination was effective in reducing pain and disability by the end of one week.
However, muscle relaxants don’t work the way you’d expect, according to Dr. Eliana Cardozo, assistant professor of rehabilitation medicine at the Icahn School of Medicine at Mount Sinai in New York City.
“It doesn’t go into the muscles and relaxes them. Instead, it works centrally on areas of our brain where we feel lethargic, which causes our body to kind of relax,” Cardoso explained.
“It’s difficult to use it during the day to get rid of the pain,” added Cardozo, who was not involved in the study.
The study found that the combination of NSAIDs and acetaminophen was associated with greater improvement than the use of NSAIDs alone.
But, Cardozo said, “When I looked at the actual data in the study, I can’t say it really made enough of a difference to add the two drugs, it was just a very small benefit.”
The study found that taking acetaminophen alone did not significantly reduce pain.
The lead author of the study, Dr. Filippo Migliorini of the Department of Orthopedics, Trauma and Reconstructive Surgery at the University Hospital Aachen, Germany, confirmed that the results of the study apply to non-persistent and chronic low back pain only.
Side effects of pain relievers
Another problem with using pain relievers is that they have potentially dangerous side effects. Acetaminophen is not recommended for use during pregnancy, and it can cause skin rashes and breathing difficulties.
Only 4,000 milligrams of acetaminophen can be used per day, and an overdose can lead to liver damage or failure, according to the National Library of Medicine.
Side effects of NSAIDs can include indigestion, diarrhea, headache, dizziness, and allergic reactions.
In rare cases, they can cause “liver, kidney, heart and circulatory problems, such as heart failure, heart attacks and strokes,” according to the UK’s National Health Service (NHS).
The authority also stated that the use of non-steroidal anti-inflammatory drugs for a period of time may lead to the formation of stomach ulcers.
“If someone is healthy and has no other problems, it’s OK to take NSAIDs around the clock for a week, but only for a week,” Cardozo said.
It is estimated that 4 out of 5 people will experience lower back pain during their lifetime, according to the Cleveland Clinic.
This condition results from the continuous deterioration of the spongy discs between the vertebrae in the back.
Anyone over the age of 30 is at increased risk of developing low back pain.
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