Trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes: "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo." "All NSAIDs have been associated with cardiovascular and gastrointestinal risks," state the authors, who found "NSAIDs were associated with higher number of patients reporting gastrointestinal adverse effects in the short-term follow-up (i.e., <14 days)."
The authors referenced additional studies showing acetaminophen/Tylenol is ineffective, and opioids appear only to offer small benefits for this condition. When this result is taken together with those from recent reviews on acetaminophen 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.
