Taking ibuprofen for a bad back might do more harm than good – study

22/03/2023

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Dr Michael Wewege co-authored a study exploring whether the benefits outweigh the side effects of taking paracetamol, for example, on lower back pain. Based at the University of New South Wales, Sydney, Dr Wewege explained “analgesics” are “widely used to treat acute non-specific low back pain”. Examples of analgesics include paracetamol, ibuprofen, and codeine and, for the study, non-specific back pain was defined as discomfort that lasts for up to six weeks.

The researchers included 98 randomised controlled trials, published between 1964 and 2021, for their analysis.

Trials compared analgesic medicines with another analgesic, placebo, or no treatment in patients reporting acute non-specific low back pain.

Dr Wewege said: “The main measures of interest were low back pain intensity at the end of treatment, on a zero to 100-point scale.

“And safety, the number of participants who reported any adverse event during treatment.

“Average pain intensity among participants at the start of each trial was 65 out of 100.”

Results, based on 15,100 adult participants and 69 different medicines or combinations, were enlightening.

Only small reductions of pain relief, scoring five to 10 points, were recorded for ibuprofen and paracetamol.

Dr Wewege said: “Low or very low confidence evidence suggested no difference between the effects of several of these medications.”

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Furthermore, there was moderate evidence of side effects of taking analgesics, such as nausea, vomiting, drowsiness, dizziness and headaches.

Fellow researcher, Professor James McAuley, added: “Our review of analgesic medicines for acute non-specific low back pain found considerable uncertainty around effects for pain intensity and safety.

“As such, clinicians and patients are advised to take a cautious approach to the use of analgesic medicines.”

Ibuprofen is a type of non-steroidal anti-inflammatory drug (NSAID), the NHS clarifies.

“Like all medicines, there’s a risk of side effects from NSAIDs,” the NHS notes.

“These tend to be more common if you’re taking high doses for a long time, or you’re elderly or in poor general health.”

Side effects can include:

Indigestion
Stomach ulcers
Drowsiness
Allergic reactions.

The NHS adds that “paracetamol on its own is not recommended for back pain” but it can be used in addition to ibuprofen.

Alternative, or additional measures, to help alleviate lower back pain includes doing stretches specific for the back.

The help of a physiotherapist can be useful as they can share the most appropriate stretches for you.

Ice or heat therapy can also be beneficial, which involves using an ice or heat pack on the affected area.

Dr Michael Wewege and Professor James McAuley’s research study can be found in the British Medical Journal (BMJ).

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