Which statement is true regarding NSAIDs for low back pain?

• A. They are equally efficacious as acetaminophen for pain.
• B. They are associated with more side effects than acetaminophen.
• C. They provide superior relief of symptoms at one week post injury.
• D. They should not be used to treat acute low back pain.

Answer: (B)

When evaluating NSAIDs for acute low back pain, the main point is weighing how well they relieve symptoms against their safety risks. NSAIDs can provide effective short-term pain relief and help with inflammation, but they come with a higher risk of adverse effects compared with acetaminophen. Common concerns include gastrointestinal irritation and ulcers, upper GI bleeding, kidney impairment, and cardiovascular risks, particularly with longer use or in susceptible individuals. Acetaminophen, on the other hand, is gentler on the stomach and kidneys but does not have anti-inflammatory effects and carries a risk of liver injury with overdose. Because of this safety profile, the statement that NSAIDs are associated with more side effects than acetaminophen is true. In practice, NSAIDs can be used for acute low back pain when appropriate, but clinicians monitor for side effects and use the lowest effective dose for the shortest duration. The other options are less accurate: NSAIDs are not universally equally efficacious with acetaminophen, their superiority at a fixed time point is not consistently guaranteed, and NSAIDs are not contraindicated for acute low back pain.