COURSE CODE COURSE NAME: Managing Lower Back Pain with NSAIDs

This essay delves into the pharmacological aspects of lower back pain, addressing the physiological mechanisms and the role of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in its management. It highlights that lower back pain, often chronic and lasting beyond three months, arises from various structural, biochemical, biomechanical, medical, and psychosocial influences. The essay emphasizes the efficacy of NSAIDs in providing short-term relief by targeting peripheral and central pain generators, acknowledging the potential gastrointestinal, renal, and cardiac toxicities associated with long-term use. It recommends short trials with low dosages to assess patient tolerance and adherence, particularly in cases of acute biochemical injury to the spine. The document concludes that NSAIDs, with their analgesic and anti-inflammatory properties, can significantly improve patient outcomes by alleviating pain, although individual responses may vary and prolonged therapeutic medication may be necessary for sustained effects. Desklib provides students access to similar solved assignments and study tools.

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Pharmacology task

Pharmacology 2
Physiology of lower back pain
Lower back pain refers to chronic pain which persist after duration of 3 months, as
most of the connective tissues often heal at 6-12 months. With lower back pain, it
experiences slower rate repair in the vascular and inter vertebral disks which affects the
resolution of painful cases referred to as lower back pain. In line with aging concepts, the
vertebral spine adjust to wear and tear due to the gravity and biochemical loading through
neuro chemical changes which form to be maladaptive and cause pain, disability state and
alteration on neurophysiology. Spinal pain is often varied and involves various structural,
biochemicals, biomechanical, medical and psychosocial influences which case pain, (Wheeler
& Murrey, 2005).
Existence of many mechanical low back pains exists; most common forms are those
that are age related causing degeneration of the disks and process on the facets and injuries
related to ligaments and muscles. Sources of this lower back pain originates from inter
vertebral disks, fractures joints structures of the neural, ligaments, muscles and fists.
The established link between inter vertebral disks and back pain has been well
established; however there is observance of alteration of the biochemical properties in the
disks structure, development of sensitive nerve endings and the growth in the vascular in
growth into degenerated disks contribute to the development of pain. Further it can yield
from loss of disk structure which alters the loading response and alignment of the spinal
column, ligaments and par spinal muscles which cases pain in the back, thus the disorder of
inters vertebral disks are major causing factor to lower back pain, (Weinstein et al, 2008).
Pharmacological actions and effects of NSAIDS
Pharmacological approach of spinal pain has been geared towards the peripheral and
central generators of pain, which rates the type of pain. The efficacy of these medicines has
often not to be conclusive and offer full recovery process for patients, however despite this
medication still remains to be the primary therapy of management, (Weinstein et al, 2014).
Research has established strong evidence NSAIDs such as those which are traditional
and the cyclooxygenase-2-specific are efficient in managing lower back pain as a short term
strategy. In a study done, randomized trials revealed that NSAIDs diflunisal have greater
efficacy of managing pain compared to acetaminophen, (Van et al, 2006). These findings
further elaborated that NSAID are efficient in managing lower back pain. However

Pharmacology 3
precaution needs to be undertaken on the long term impact of toxicities of gastro intestinal,
renal and cardiac effects on its use for the patient, (Van et al, 2006).
Further in cases where there is acute biochemical injury on the spine especially for the
patient in the case study, the use of NSAIDs medication are beneficial in managing the pain,
(Martell et al, 2007). With the concerns of toxicities and reactions of these medicines, short
trial should be undertaken at low dosage for an estimate of 3-4 days to assess the
effectiveness of patient tolerances and adherence to the drug for the patient. Further it assists
in alleviating pain, however different patients often require therapeutic medication over long
durations for the effects to be felt, (Mlanage & Wolff, 2008).
Thus NSAIDS, have both analgesics and anti inflammatory attributes which affect the
patho physiological process. Trials done have shown that this medication are crucial for
managing pain. Thus this medication will improve the score on the patient through alleviating
pain.
References
Malanga, G., & Wolff, E. (2008). Evidence-informed management of chronic low back pain
with nonsteroidal anti-inflammatory drugs, muscle relaxants, and simple analgesics.
The Spine Journal, 8(1), 173-184.
Martell, B. A., o'Connor, P. G., Kerns, R. D., Becker, W. C., Morales, K. H., Kosten, T. R.,
& Fiellin, D. A. (2007). Systematic review: opioid treatment for chronic back pain:
prevalence, efficacy, and association with addiction. Annals of internal medicine,
146(2), 116-127.
van Tulder, M. W., Koes, B., & Malmivaara, A. (2006). Outcome of non-invasive treatment
modalities on back pain: an evidence-based review. European spine journal, 15(1),
S64-S81.
Weinstein, J. N., Tosteson, A. N., Tosteson, T. D., Lurie, J., Abdu, W. A., Mirza, S. K., ... &
Nelson, E. C. (2014). The SPORT value compass: do the extra costs of undergoing
spine surgery produce better health benefits?. Medical care, 52(12), 1055.
Weinstein, J. N., Tosteson, T. D., Lurie, J. D., Tosteson, A. N., Blood, E., Hanscom, B., ... &
Hilibrand, A. (2008). Surgical versus nonsurgical therapy for lumbar spinal stenosis.
New England Journal of Medicine, 358(8), 794-810.
Wheeler, A. H., & Murrey, D. B. (2005). Spinal pain: pathogenesis, evolutionary
mechanisms, and management. The neurological basis of pain. New York: McGraw-
Hill, 421-52