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NSAIDs are commonly used for pain management. They reduce inflammation and pain by reducing the activity of cyclo-oxygenase (or COX) enzymes and by inhibiting the synthesis of prostaglandins.1
National Institute for Health and Care Excellence (NICE) guidelines recommend NSAIDs as first-line pain relievers for low back pain and sciatica2 and osteoarthritis.3 They are also used for musculoskeletal pain caused by acute injury. In England, there were around 11.5 million prescriptions for oral NSAIDs in 2018.4 In the United States, about 60% of patients with osteoarthritis or chronic low back pain are prescribed NSAIDs, based on an analysis of records in a claims database in 2008.5
Research strategy
We searched PubMed (NLM database) and the Cochrane Library for the terms “nonsteroidal anti-inflammatory drugs” OR “NSAIDs” AND “spinal pain” OR…
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