Non-steroidal Anti-inflammatory Drugs for Sciatica

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Non-steroidal Anti-inflammatory Drugs for Sciatica
Key Take-Away: 

Sciatica is a condition that results in nerve pain, numbness and weakness radiating from lower back to legs. There is a low-quality evidence for pain reduction, overall improvement and adverse effects in sciatica patients administered with nonsteroidal anti-inflammatory drugs (NSAIDs).

Sciatica is a condition causing nerve pain, numbness and weakness radiating from lower back to legs.

ABSTRACT: 
Background: 

Sciatica is a condition causing nerve pain, numbness and weakness radiating from lower back to legs. NSAIDs are one of the most frequently prescribed drugs for sciatica.

The presented systematic review and meta-analysis aimed to determine the efficacy of NSAIDs on pain reduction, overall improvement and reported adverse effects in people with sciatica.

Methods: 

The 2008 Cochrane Review was updated through June 2015. Randomized controlled trials that compared NSAIDs with placebo, with other NSAIDs, or with other medication were included.

Outcomes included pain using mean difference (MD, 95% confidence intervals [95% CI]). For global improvement and adverse effects risk ratios (RR, 95% CI) were used. We assessed the level of evidence using the Grades of Recommendation, Assessment, Development and Evaluation approach.

Results: 

The review included a total of ten trials (N = 1651). Nine out of ten trials were assessed for high risk of bias.

For pain reduction (visual analog scale, 0 to 100), NSAIDs were no more effective than placebo (MD −4.56, 95% CI −11.11 to 1.99, quality of evidence: very low). For global improvement, NSAIDs were more effective than placebo (RR 1.14 [95% CI 1.03 to 1.27], low quality of evidence). One trial reported the effect of NSAIDs on disability with very low-quality evidence that NSAIDs are no more effective than placebo. There was a low-quality evidence that the risk for adverse effects is higher for NSAID than placebo (RR 1.40, 95% CI 1.02 to 1.93).

Conclusion: 

There is a low-quality evidence supporting that NSAIDs is better than placebo for global improvement and the higher risk of adverse effects using NSAIDs compared with placebo.

The findings must be interpreted with caution, due to small study samples, inconsistent results, and a high risk of bias in the included trials.

Source:

Spine

Link to the source:

http://journals.lww.com/spinejournal/Abstract/2017/04150/Nonsteroidal_An...

The original title of the article:

Nonsteroidal Anti-inflammatory Drugs for Sciatica: An Updated Cochrane Review

Authors:

Rasmussen-Barr et al.

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