Preview

Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Efficacy and safety of different nonsteroidal anti-inflammatory drugs for acute neck and back pain

https://doi.org/10.14412/2074-2711-2020-2-42-47

Full Text:

Abstract

Objective: to comparatively study several nonsteroidal anti-inflammatory drugs (NSAIDs) (their analgesic effect; dynamics of quality of life; side effects, such as NSAID-gastropathy and gastric dyspepsia) in acute pain in the neck and back (dorsalgia).

Patients and methods. The investigators followed up 120 patients (4 groups, each having 30 people) with acute dorsalgia who took different oral NSAIDs for 7 days: long-acting ketoprofen, aceclofenac, naproxen, and dexketoprofen (Flamadex). To evaluate their possible side effects, dyspepsia symptoms were monitored and blood pressure (BP) was measured daily; gastroscopy was repeated after completion of a treatment cycle. The Nottingham Quality of Life Questionnaire and the Visual Analogue Scale (VAS) for pain were used.

Results and discussion. A gradual and substantial reduction in pain measured according to VAS was noted in all the NSAID-treated groups. The intensity of pain syndrome decreased faster in the dexketoprofen group; the analgesic effect of naproxen and long-acting aceclofenac was significantly less (p=0.012 and 0.002, respectively). This patient group showed a tendency to maximum improvement according to the Nottingham Quality of Life Questionnaire and VAS. Elevated BP was observed in all the groups, but statistically significantly more frequently in the naproxen group (p=0.05). Gastric dyspepsia was also registered in all the groups, but a tendency to its lower frequency was seen in the
dexketoprofen group.

Conclusion. Dexketoprofen showed fewer side effects and a more pronounced analgesic effect than ketoprofen, aceclofenac, and naproxen in acute dorsalgia.

About the Authors

E. Yu. Plotnikova
Department of Outpatient Therapy, Postgraduate Training, and Nursing, Kemerovo State Medical University, Ministry of Health of Russia
Russian Federation
22, N. Ostrovsky St., Kemerovo 650000, Russia



V. N. Zolotukhina
M.A. Podgorbunsky Kemerovo Regional Clinical Emergency Hospital
Russian Federation
22, N. Ostrovsky St., Kemerovo 650000, Russia



L. K. Isakov
Department of Outpatient Therapy, Postgraduate Training, and Nursing, Kemerovo State Medical University, Ministry of Health of Russia
Russian Federation
22, N. Ostrovsky St., Kemerovo 650000, Russia



M. N. Sinkova
Department of Outpatient Therapy, Postgraduate Training, and Nursing, Kemerovo State Medical University, Ministry of Health of Russia
Russian Federation
22, N. Ostrovsky St., Kemerovo 650000, Russia



M. A. Sinkov
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
6, Sosnovyi Boulevard, Kemerovo 650002, Russia



References

1. Guidelines for the management of acute nonspecific low back pain in primary care.

2. http://www.backpaineurope.org/web/files/WG1_Guidelines.pdf.

3. Carr DB, Goudas LC. Acute pain. Lancet. 1999 Jun 12;353(9169):2051-8.

4. Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine. Acute pain management. 3rd ed. 2010. http://www.anzca.edu.au/fpm/resources/books-and-publications/publications-1/Acute Pain - final version.pdf.

5. Joshi GP, Ogunnaike BO. Consequences of inadequate postoperative pain relief and chronic persistent postoperative pain. Anesthesiol Clin North Am. 2005 Mar;23(1):21-36.

6. Schiller JS, Lucas JW, Ward BW, Peregoy JA. Summary health statistics for U.S. adults: National Health Interview Survey, 2010. Vital Health Stat 10. 2012 Jan;(252):1-207.

7. Centers for Disease Control and Prevention. National Ambulatory Medical Care Survey: 2009 summary tables. http://www.cdc.gov/nchs/data/ahcd/namcs_summary/2009_namcs_web_tables.pdf.

8. Blondell RD, Azadfard M, Wisniewski AM. Pharmacologic therapy for acute pain. Am Fam Physician. 2013 Jun 1;87(11):766-72.

9. Kuritzky L, Samraj GP. Nonsteroidal antiinflammatory drugs in the treatment of low back pain. J Pain Res. 2012;5:579-90. doi: 10.2147/JPR.S6775. Epub 2012 Nov 28.

10. Medicines and Healthcare products Regulatory Agency (2013) Drug safety update Diclofenac: new contraindications and warnings (MHRA, London) https://www.gov.uk/drugsafety-update/diclofenac-new-contraindications-and-warnings. 10. Courtney P, Doherty M. Key questions concerning paracetamol and NSAIDs for osteoarthritis. Ann Rheum Dis. 2002 Sep;61(9):767-73.

11. Sussman JB, Kerr EA, Saini SD, et al. Rates of deintensification of blood pressure and glycemic medication treatment based on levels of control and life expectancy in older patients with diabetes mellitus. JAMA Intern Med. 2015 Dec;175(12):1942-9. doi: 10.1001/jamainternmed.2015.5110.

12. Machado GC, Maher CG, Ferreira PH, et al. Non-steroidal anti-inflammatory drugs for spinal pain: a systematic review and metaanalysis. Ann Rheum Dis. 2017 Jul;76(7): 1269-1278. doi: 10.1136/annrheumdis-2016-210597. Epub 2017 Feb 2.

13. Kuritzky L. Pain in the ambulatory setting: the role of nonsteroidal anti-inflammatory drugs. Primary Care Special Edition. 2003;(7):9–12.

14. Cannon GW, Breedveld FC. Efficacy of cyclooxygenase-2 specific inhibitors. Am J Med. 2001 Feb 19;110 Suppl 3A:6S-12S.

15. Pollison R. Nonsteroidal anti-inflammatory drugs: practical and theoretical considerations in their selection. Am J Med.1996;100:31S–36S.

16. Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007 Oct 2;147(7):478-91.

17. NICE Guideline [NG59] Low back pain and sciatica in over 16s: assessment and management NICE guideline [NG59] Published date: November 2016

18. Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-530. doi: 10.7326/M16-2367. Epub 2017 Feb 14.

19. Kuritzky L, Samraj GP. Nonsteroidal antiinflammatory drugs in the treatment of low back pain. J Pain Res. 2012;5:579-90. doi: 10.2147/JPR.S6775. Epub 2012 Nov 28.

20. Roudsari B, Jarvik JG. Lumbar Spine MRI for Low Back Pain: Indications and Yield. AJR Am J Roentgenol. 2010 Sep;195(3):550-9. doi: 10.2214/AJR.10.4367.


For citation:


Plotnikova E.Yu., Zolotukhina V.N., Isakov L.K., Sinkova M.N., Sinkov M.A. Efficacy and safety of different nonsteroidal anti-inflammatory drugs for acute neck and back pain. Neurology, Neuropsychiatry, Psychosomatics. 2020;12(2):42-47. (In Russ.) https://doi.org/10.14412/2074-2711-2020-2-42-47

Views: 210


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)