Therapeutic efficacy of nonsteroidal anti-inflammatory drug therapy versus exercise therapy in patients with chronic nonspecific low back pain: a prospective study

Fukushima J Med Sci. 2017 Apr 28;63(1):8-15. doi: 10.5387/fms.2016-12. Epub 2017 Mar 22.

Abstract

Therapy for chronic, nonspecific low back pain is mainly conservative: medication and/or exercise. Pharmacotherapy, however, has side effects, and the quantities of concomitant drugs in older persons require attention. Although exercise promises improved function, its use to alleviate pain is controversial. Thus, we compared the efficacy of pharmacotherapy versus exercise for treating chronic nonspecific low back pain. The pharmacotherapy group (n=18: 8 men, 10 women) were prescribed celecoxib monotherapy. The exercise group (n=22: 10 men, 12 women) undertook stretching exercises. Because of drop-outs, the NSAID group (n=15: 7 men, 8 women) and the exercise group (n =18: 8 men, 10 women) were finally analyzed. We applied a visual analog scale, Roland-Morris disability scores, and the 36-Item Short Form Health Survey. We used a paired t-test for within-group analyses and an unpaired t-test for between-group analyses. Pain relief was achieved after 3 months of pharmacotherapy or exercise. Quality of life improved only in the exercise group. Recovery outcomes for the two groups were not significantly different. Efficacy of exercise therapy for strictly defined low back pain was almost equivalent to that of pharmacotherapy and provided better quality of life.

Keywords: 36-Item Short-Form Health Survey; Chronic nonspecific low back pain; Exercise; Nonsteroidal anti-inflammatory drug; Roland Morris Disability Questionnaire score.

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Chronic Disease
  • Exercise Therapy*
  • Female
  • Humans
  • Low Back Pain / drug therapy
  • Low Back Pain / therapy*
  • Male
  • Middle Aged
  • Pain Management
  • Pain Measurement
  • Prospective Studies
  • Quality of Life
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal