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Monday, 6 February 2017

Painkillers may not kill pain very well. But they still have serious side effects

New research has found that NSAID painkillers have no more effect than placebo in the treatment of back pain, but continue to cause patient harm.

The study, entitled "Non-steroidal anti-inflammatory drugs for spinal pain: a systematic review and meta-analysis" examined 35 randomised controlled trials, covering over 6,000 patients, that compared the efficacy of painkilling drugs with placebo control groups. It found that the drugs did reduce pain for a short period, but that overall "the effect was not clinically important", and that those on placebo control groups did equally well.

               "In summary, compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short term."

However, the team from the University of Sydney in Australia also found that the patients taking NSAID painkillers s were 2.5 times more likely to suffer from the well known adverse reactions to the drugs, notably adverse gastrointestinal complications than those taking placebo.

So whilst these pharmaceutical drugs are of little of no benefit, they continue to be a major threat to our health because of their harmful and damaging side effects!

Another noteworthy feature of the study was that it compared this finding with the current guidelines of NICE, the National Institute of Clinical Excellence in Britain. These guidelines were only recently updated, and made NSAID painkillers the 'first choice treatment' for low back pain. This advice followed similar findings about the ineffectiveness of Paracetamol (Acetamorfen in the USA), and the dangers of opioid painkillers.

So NICE does have a difficult task! What are they supposed to do? The three main groups of painkilling drugs available for conventional doctors don't work! But they do damage to patients. So perhaps their clinical guidelines should now be rewritten again, admitting that there are no safe painkillers, and no effective painkillers. At least this would be a more honest assessment of the situation conventional medicine now finds itself.

Yet NICE could be more positive. It could advise us all to look towards alternative medical therapies, like Homeopathy and Acupuncture, in recognition that if they are truly to pursue their objective of  'clinical excellence' the pharmaceutical industry no longer has anything to offer.

I have noticed several comments from doctors about this situation. One reflected sadly that "instead of everyone falling over themselves to say what we can't use, how about what we CAN use?" Clearly, the doctors cupboard is bare! The solution for conventional doctors is the same. They need to recognise that there are no safe or effective painkillers, and instead, they need to refer their patients to alternative medical therapies. In this way they will find that their patients are treated more effectively, and more safely.

Indeed, the lack of side effects of alternative medical treatment might also mean that patients do not have to  keep returning to the surgery, and doctors will not find themselves so stretched, and the NHS not in such a crisis!