SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2011
A systematic review on the effectiveness of pharmacological interventions for chronic non-specific low-back pain.
Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
76 citing papers in PubMed, 4 syntheses or guidelines pooled it, 219 citations in OpenAlex.
- Beyond Depression: The Role of Antidepressants in Managing Chronic Temporomandibular Disorders. A Systematic Review.Journal of oral rehabilitation · 2025Pooled it
- [Conservative treatment of nonspecific, chronic low back pain : Evidence of the efficacy - a systematic literature review].Der Orthopade · 2016Pooled it
- Non-steroidal anti-inflammatory drugs for chronic low back pain.The Cochrane database of systematic reviews · 2016Pooled it
- Opioids compared to placebo or other treatments for chronic low-back pain.The Cochrane database of systematic reviews · 2013Pooled it
- Assessment of a taping method combined with manual therapy as a treatment of non-specific chronic low back pain - a randomized controlled trial.BMC musculoskeletal disorders · 2021Trial
- Immediate effect of pain neuroscience education for recent onset low back pain: an exploratory single arm trial.The Journal of manual & manipulative therapy · 2019Trial
- Efficacy of Low-Dose Amitriptyline for Chronic Low Back Pain: A Randomized Clinical Trial.JAMA internal medicine · 2018Trial
- Effect of single-dose imipramine on chronic low-back and experimental pain. A randomized controlled trial.PloS one · 2018Trial
- Efficacy of a modern neuroscience approach versus usual care evidence-based physiotherapy on pain, disability and brain characteristics in chronic spinal pain patients: protocol of a randomized clinical trial.BMC musculoskeletal disorders · 2014Trial
- Who should undergo surgery for degenerative spondylolisthesis? Treatment effect predictors in SPORT.Spine · 2013Trial
- Trial
- French National Guidelines for the Appropriate Use of Opioids: Analgesia, Opioid Use Disorder, and Overdose Prevention-Part 1: Methodology and Pain Management.Pain and therapy · 2026Article
- Effect of Acupuncture for Chronic Nonspecific Low Back Pain: Study Protocol for a Randomized Double-Blind, Placebo-Controlled Trial.JMIR research protocols · 2026Article
- Perception gaps between healthcare professionals and people with CLBP: an online survey of current primary care management practices in the United Kingdom.Annals of medicine · 2025Article
- What a pain in the back: etiology, diagnosis and future treatment directions for discogenic low back pain.Bone research · 2025Review
- Volumetric measurement of herniated disc material as a predictor of outcome in periradicular therapy.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Updated meta‑analysis on the therapeutic effects of botanical extract interventions for chronic lower back pain.Experimental and therapeutic medicine · 2025Article
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16 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The objective of this review was to determine the effectiveness of pharmacological interventions [i.e., non-steroid anti-inflammatory drugs (NSAIDs), muscle relaxants, antidepressants, and opioids] for non-specific chronic low-back pain (LBP). Existing Cochrane reviews for the four interventions were screened for studies fulfilling the inclusion criteria. Then, the literature searches were updated. Only randomized controlled trials on adults (≥18 years) with chronic (≥12 weeks) non-specific LBP and evaluation of at least one of the main clinically relevant outcome measures (pain, functional status, perceived recovery, or return to work) were included. The GRADE approach was used to determine the quality of evidence. A total of 17 randomized controlled trials was included: NSAIDs (n = 4), antidepressants (n = 5), and opioids (n = 8). No studies were found for muscle relaxants; 14 studies had a low risk of bias. The studies only reported effects on the short term (<3 months). The overall quality of the evidence was low. NSAIDs and opioids seem to lead to a somewhat higher relief in pain on the short term, as compared to placebo, in patients with non-specific chronic low back pain; opioids seem to have a small effect in improving function for a selection of patients who responded with an exacerbation of their symptoms after stopping their medication. However, both types of medication show more adverse effects than placebo. There seems to be no difference in effect between antidepressants and placebo in patients with non-specific chronic LBP.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.