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Expert Opin Pharmacother. 2018 Apr;19(6):537-545. doi: 10.1080/14656566.2018.1454430. Epub 2018 Mar 26.

Pharmacotherapy for chronic non-specific low back pain: current and future options.

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a Department of General Practice , Erasmus MC , Rotterdam , The Netherlands.



Low back pain is associated with a large burden-of-illness. It is responsible for the most years lived with disability as compared with any other medical condition. A comprehensive overview of the evidence on pharmacological treatment options for chronic low back pain is lacking. This review evaluates the evidence for the benefits and risks of currently available pharmacological treatments for chronic low back pain.


The authors focus on the recent (Cochrane) systematic reviews and meta-analyses of randomized clinical trials covering paracetamol (acetaminophen), NSAIDs, muscle relaxants, antidepressants, anticonvulsants, opioids, and other (new) drugs.


The overall impression of the efficacy of pharmacological treatments for patients with chronic low back pain is rather sobering. The effects on pain reduction and improvement of function are commonly small to moderate and short lasting when compared to placebo. At the same time, the various types of drugs are not without side-effects. This holds especially true for serious side-effects associated with (prolonged) use of strong opioids. Future studies on patients with chronic back pain should aim to identify subgroups of patients with good response to specific pharmacological treatment to facilitate personalized care.


Anticonvulsants; NSAIDs; acetaminophen; antidepressants; chronic low back pain; melatonin; muscle relaxants; opioids; paracetamol; pharmacotherapy; review

[Indexed for MEDLINE]

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