Overview of NSAID use
Australian and New Zealand College of Anaesthetists (ANZCA), 2020Day, 2013
Nonsteroidal anti-inflammatory drugs (NSAIDs) include nonselective cyclo-oxygenase (COX) inhibitors and COX-2–selective inhibitors (the latter group is sometimes referred to as coxibs). They are commonly used to provide symptom relief for acute and chronic musculoskeletal pain because of their analgesic and anti-inflammatory effects, but require careful consideration of their potential benefits and harms for each patient. If used, they should be part of a multidimensional approach to pain management. The principles of NSAID use for musculoskeletal pain are discussed in this topic. Indication-specific recommendations are included in the clinical topics, alongside appropriate nonpharmacological strategies. An overview of nonpharmacological therapies is given in:
When using an NSAID for musculoskeletal pain a trial approach is recommended. NSAID efficacy and safety should be regularly reviewed. Treatment should be tapered or stopped if management goals (eg improved function and quality of life, a modest reduction in pain) are not met or the patient experiences intolerable adverse effects. Periodically consider a dose reduction or treatment cessation.
Clinicians should keep in mind that NSAIDs are available over-the-counter, including in combination products (eg combined with paracetamol). Patients may have already tried, or be taking, an NSAID for symptom relief at the time they seek medical advice.
For comprehensive drug information, including precautions, contraindications, adverse effects and drug interactions, consult an appropriate drug information resource.