Anti-Inflammatory Treatment in Chronic Back Pain

Objectives. To analyze the causes of the non-use of nonsteroidal anti-inflammatories (NSAID) and discontinuation of previously used NSAID treatment in patients with chronic nonspecific back pain (CBP). Materials and methods. Treatment was analyzed in 250 patients with CBP initially and at one and two years. Results and conclusions. A total of 52 CBP patients (20.8%) did not receive NSAID, 38 patients (15.2%) consistently received NSAID frequently (on four or more days per week), 44 patients (17.6%) received NSAID consistently at low frequency (on three or fewer days per week), 62 patients (24.8%) received courses of NSAID, and 54 (21.6%) received NSAID as needed. The absence of NSAID treatment in CBP was associated with older age, the presence of comorbid states, nonalcoholic fatty liver disease, and obesity. Discontinuation of previously used NSAID was equally linked with resolution of pain and the failure to respond to treatment, with excess body weight, and use of nonselective NSAID. Continuation of effective anti-inflammatory treatment was associated with the use of coxibs, use of Neurobion, normal body weight, and achievement of reductions in pain syndrome even if complete resolution was not attained. Increases in treatment compliance could be achieved by increasing efficacy by using NSAID (especially coxibs) in complex with group B vitamins (B₁, B₆, B₁₂), normalization of body mass index, and effective control of liver function.

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