NSAIDs do not offer clinically important benefits for back pain above those attributable to placebo, a systematic review by The George Institute concludes.

Published in the Annals of the Rheumatic Diseases the review involved 35 trials involving more than 6000 people.

It found that six patients needed to be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term.

NSAIDs were also found to increase the risk of gastrointestinal adverse effects by 2.5 times compared with placebo, although the authors noted the safety data were limited to trials that used non-selective NSAIDs.

“When this result is taken together with those from recent reviews on paracetamol and opioids, it is now clear that the three most widely used, and guideline-recommended medicines for spinal pain do not provide clinically important effects over placebo,” wrote the authors led by Associate Professor Ferreira, a Senior Research Fellow at The George Institute and at the Institute of Bone and Joint Research.

“There is an urgent need to develop new analgesics for spinal pain,” they concluded.