title: A study on factors affecting low back pain and safety and efficacy of NSAIDs in acute low back pain in a tertiary care hospital of Western Nepal.
abstract: BACKGROUND
  Low back pain is characterized by a range of symptoms which include pain, muscle tension or stiffness, and is localized between the shoulder blades and the folds of the buttocks, with or without spreading to the legs. Non-Steroidal Anti Inflammatory Drugs (NSAIDs) are the drugs of choice which provide an analgesic effect for acute low back pain.
  
  
  OBJECTIVE
  To study the factors affecting low back pain, efficacy and safety of different non-steroidal anti-inflammatory drugs (aceclofenac, diclofenac, naproxen and nimesulide) in low back pain.
  
  
  METHODS
  Data collection form and numeric pain rating scale were used as study tools for studying patients' demographies and severities of pain respectively. Patients prescribed with aceclofenac 100 mg , diclofenac 100 mg, naproxen 500 mg and nimesulide 100 mg for acute low back pain at Orthopaedics Outpatients Department of Manipal Teaching Hospital, Nepal, were enrolled in this study. The decrease in pain scores was recorded on 5th and 10th days of follow-up and pain scores were calculated. Descriptive statistics and Kruskal Wallis non parametric test were used for analysis.
  
  
  RESULTS
  Among 150 patients, 67.3% were females (n=101). Low back pain was more prevalent (24.7%) in age-group of 59-68 years and a positive correlation was seen. Similarly, low back pain was found to be high among people involved in agriculture, heavy weight lifters and non smokers. The decrease in average pain scores was more in the patients treated with aceclofenac (4.83 ± 0.537), followed by that in those who were treated with naproxen (4.13 ± 0.067) and diclofenac (3.84 ± 0.086). The decrease in pain scores was found to be lowest among patients who were treated with nimesulide (2.11 ± 0.148). Nimesulide presented more number of side-effects than the comparative drugs.
  
  
  CONCLUSIONS
  Different factors affect low back pain, such as age, gender, personal habit, posture, occupation, weight lifting. Aceclofenac showed greater decrease in pain scores with lesser number of side-effects.
authors.affiliation: Pharm D, Kathmandu University , Dhulikhel, Kavre, Nepal .
authors.forename: Srijana
authors.initials: S
authors.lastname: Bhattarai
authors.affiliation: Asssistant Professor, Kathmandu University , Dhulikhel, Kavre, Nepal .
authors.forename: Himal Paudel
authors.initials: HP
authors.lastname: Chhetri
authors.affiliation: Assistant Professor, Manipal College of Medical Sciences , Deep, Pokhara, Nepal .
authors.forename: Kadir
authors.initials: K
authors.lastname: Alam
authors.affiliation: Lecturer, Manipal College of Medical Sciences , Deep, Pokhara, Nepal .
authors.forename: Pabin
authors.initials: P
authors.lastname: Thapa
keywords: Low back pain; Non-steroidal anti-inflammatory drugs; Pain scale