Back pain is one of the most common reasons for visiting a doctor.. And of course, the issues of effective help with these symptoms are very relevant.. Before dwelling on drugs, it is necessary to note the general principles of treatment, which have an important role.

These include providing information to the patient about the possible causes of back pain, the role of an active lifestyle and dosed physical activity, avoiding prolonged bed rest.. Therapy for back pain involves the use of drugs that affect the main mechanisms of pain development, including inflammation, painful muscle tension, and malnutrition of the nervous tissue1.

One of the first drugs used for this condition are non-steroidal anti-inflammatory drugs (NSAIDs) and they can not only remove pain, but also affect the inflammatory component. There are general rules for the appointment of these funds and we will dwell on some aspects in more detail:.

NSAIDs are prescribed immediately after diagnosis, preferably by mouth at medium or maximum therapeutic dosage;

The duration of administration is determined by the time required to obtain the maximum analgesic effect and restore the function of movement.;

The criterion for good efficacy is the reduction of pain by at least 50% of the initial level and no later than 5-7 days after the administration of the drug in a full dose.;

The ineffectiveness of therapy within 2-4 weeks is the basis for the appointment of a consultation with a neurologist;

When prescribing NSAIDs, the risk of adverse events should always be considered.;

Do not combine two or more different drugs in this group, as well as use doses exceeding the recommended1.

The effects of drugs in this group are provided by the blockade of key enzymes involved in the metabolism of arachidonic acid and the processes of inflammation and the development of pain in the body (cyclooxygenase 1 and 2). At the same time, the blockade of the first enzyme reduces the protective potential of the gastric mucosa and makes it possible to damage it under the influence of external aggressive factors, which leads to the development of complications from the gastrointestinal tract2.

NSAIDs are subdivided depending on the predominant blockade of these enzymes:.

Non-selective t. those that block both enzymes, e.g.

diclofenac, indomethacin, ketoprofen, naproxen.

Predominantly selective. e blocking mainly COX2 (nimesulide, meloxicam) and highly selective (coxibs).

It is selectivity that ensures optimal safety.. Etoricoxib is a prominent representative of highly selective drugs.. In several large studies, this drug has shown a good safety profile with respect to complications associated with gastropathies and the development of gastric and duodenal ulcers3,4.

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