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The decision regarding the use of NSAIDs for sciatica should be cautiously considered as NSAIDs were not found to be effective than placebo in reducing short-term pain in patients with sciatica.
NSAIDs are one of the regularly prescribed medication for relieving sciatica pain. But, there is lack of data showing the efficacy and safety of NSAIDs in patients with sciatica.
Recently, a study was conducted by Rasmussen-Barr and colleagues to study the efficacy of NSAIDs on pain and the overall recovery in patients with sciatica. The adverse effects reported by the patients were also studied. For evaluation, researchers updated a 2008 Cochrane Review through June 2015. The randomized controlled trials which contained the comparison of NSAIDs to placebo, with other NSAIDs, or with other medications, were included. The change in pain was evaluated by using mean differences. Risk ratios were used to assess global improvement & adverse effects. Further, the level of evidence was determined through the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) approach.
A total of ten trials were included in the study. Out of 10, nine were determined at high risk of bias. NSAIDs were not effective than placebo for pain reduction. However, in case of global improvement, NSAIDs were more effective than placebo. But, the supporting evidence was of low quality. One of the trials reported the effect of NSAIDs on disability with very low-quality evidence. It showed that NSAIDs are no more effective than placebo. Also, the risk for adverse effects is higher for NSAID than placebo, but with low-quality evidence.
The study showed very low-quality evidence that the effectiveness of NSAIDs for pain reduction is similar with that of placebo. Also, there was low quality of evidence that NSAIDs shows better global improvement than placebo and low quality of evidence that the risk of adverse effects with NSAIDs is higher than placebo.
The findings of the study recommend all the researchers to interpret data regarding NSAIDs with the attention due to small study samples, high risk of bias in trials and inconsistent results.
Spine
Nonsteroidal Anti-inflammatory Drugs for Sciatica: An Updated Cochrane Review
Rasmussen-Barr E et al.
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