Article

Many medications have been evaluated for the treatment of nonspecific low back
pain. The only medications proven to be more effective than a placebo in chronic
low back pain are nonsteroidal antiinflammatory drugs (NSAIDs), the
acetaminophen-tramadol combination, antidepressants other than selective
serotonin reuptake inhibitors, and some types of spinal applications of
glucocorticoids or local anesthetics. However, the efficacy of these drugs in
inducing pain relief is limited, and NSAIDs are the only drugs that also improve
function. Nevertheless, the outcome of nonspecific low back pain is favorable in
most cases, even in placebo-treated patients. In addition, treatment effects vary
dramatically across studies. One factor in this variability is the heterogeneity
of patient populations. To improve the uniformity of patient populations enrolled
in therapeutic trials, the selection criteria should take into account the
nociceptive, dysfunctional, and possible neuropathic components of the pain
syndrome.
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Langue : ANGLAIS