Ibuprofen plus paracetamol versus ibuprofen in acute low back pain
Low back pain is caused by injury to a muscle (strain) or ligament (sprain) which can be due to lack of regular excercise, fracture, improper lifting, poor posture, arthritis or ruptured disk. The study mentioned here has been used to depict whether combination of ibuprofen and paracetamol is more effective than ibuprofen in monotherapy, in the treatment of acute low back pain.
As per the technique followed, 80 adult patients with acute low back pain were randomized into two subgroups. For three consecutive days, 40 patients were treated with ibuprofen 400mg three times a day in the first subgroup and patients in the second subgroup (n=40) were treated with a fixed-dose combination tablet of ibuprofen 200mg along with paracetamol 325mg. The patients were followed for another 7 days. Efficacy and tolerability of both treatment options was evaluated.
In both the subgroups of patients, a statistically significant decrease in pain intensity, assessed using a visual analogue scale and the 5-point Likert scale was noticed. Although, intensity of pain on Day 4 was significantly lower in patients treated with combined therapy (t=2.05, p=0.045). Appreciable improvement in mobility of the lumbar spine was viewed in both subgroup of patients, but at the end of the follow up period, finger-to-floor distance was lower in patients on combined therapy (4.7cm vs. 8.3cm, t=2.27, p=0.03). Regardless of treatment, improvement of functional ability on Day 4 and Day 10 was significant. Minor gastric intolerability was reported by one patient on combined therapy and two patients on ibuprofen monotherapy.
Hence, compared to ibuprofen monotherapy, combination of ibuprofen and paracetamol may impart faster and longer analgesic effect in patients with acute low back pain, with equally favorable effect on mobility & functional ability and similar tolerability.