Pharmacotherapy of chronic low back pain: an analysis of efficacy and adverse effects
DOI:
https://doi.org/10.55892/jrg.v8i19.2756Keywords:
Low Back Pain, Chronic Low Back Pain, Treatment, Adverse Effects, EfficacyAbstract
INTRODUCTION: Low back pain affects approximately 60% to 90% of the adult population worldwide, and approximately a quarter of these may develop chronic low back pain (CL). Due to its high prevalence, CL generates significant health care costs worldwide. It is worth noting that many cases of low back pain are non-specific, difficult to diagnose, and difficult to treat. OBJECTIVE: To determine the best pharmacological treatment options for CL and to identify side effects. METHODOLOGY: This is an integrative literature review that used the virtual libraries of Pubmed, BVS and SciELO as a database, based on the guiding question: “Which drugs are most effective and have the lowest incidence of adverse effects in controlling chronic low back pain?”. The inclusion and exclusion criteria were rigorously defined, selecting articles published between 2015 and 2024, and were carried out in five phases, using the Flow diagram to guide the search for publications. RESULTS: 423 articles were found, 96 in Pubmed, 325 in BVS and two in SciELO. After the exclusion steps, 415 articles were excluded, leaving eight articles to compose the present review. DISCUSSION: Despite reports of arthralgia as an adverse effect, fasinumab and tanezumab were effective in controlling CL. Intrathecal infusion of fentanyl/bupivacaine was effective in patients with intractable CL. NKTR-181 and cebranopadol showed good efficacy and less abuse potential. Tapentadol combined with pregabalin was more effective, but with greater adverse effects. Celecoxib outperformed paracetamol in pain relief, while duloxetine stood out in improving pain in patients who did not respond to NSAIDs. CONCLUSION: The analysis of pharmacological treatment for CL revealed new effective options, with fewer adverse effects. The choice of treatment must be individualized to optimize results and reduce risks.
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