From the Guidelines
Voltaren (diclofenac) is a viable option for managing low back pain, particularly when the pain is related to inflammation, as it has been shown to provide small to moderate, primarily short-term effects on pain. As a nonsteroidal anti-inflammatory drug (NSAID), diclofenac works by reducing substances in the body that cause pain and inflammation. For acute low back pain, the typical dosage is 50 mg taken 2-3 times daily or 75 mg twice daily, with a maximum daily dose of 150 mg, as suggested by studies such as 1. The topical gel formulation (Voltaren Gel) can also be applied directly to the affected area 3-4 times daily.
Some key points to consider when using Voltaren for low back pain include:
- Treatment duration should generally be limited to 7-10 days for acute pain to minimize side effect risks, as prolonged use can lead to gastrointestinal and renovascular risks 1.
- Diclofenac may be more effective when combined with other treatments like physical therapy, proper posture, and gentle stretching.
- It's essential to note that while diclofenac can help manage symptoms, it doesn't address underlying causes of back pain.
- Side effects can include stomach irritation, ulcers, increased blood pressure, and kidney problems, so it should be used at the lowest effective dose for the shortest time possible, especially in older adults or those with heart, kidney, or liver conditions, as highlighted in studies such as 1 and 1.
Overall, the decision to use Voltaren for low back pain should be based on a careful assessment of the potential benefits and risks, considering the individual patient's medical history and current health status.
From the Research
Effectiveness of Voltaren for Low Back Pain
- The effectiveness of Voltaren (diclofenac) for managing low back pain is a topic of debate, with some studies suggesting that it may not be significantly more effective than a placebo 2.
- A randomized controlled trial found that the addition of diclofenac to recommended first-line treatment for acute low back pain did not result in faster recovery compared to placebo 2.
- Another study found that the overall impression of the efficacy of pharmacological treatments, including NSAIDs like diclofenac, for chronic low back pain is rather sobering, with small to moderate and short-lasting effects on pain reduction and improvement of function compared to placebo 3.
Comparison with Other Treatments
- A systematic review found that muscle relaxants, which are sometimes used in combination with NSAIDs like diclofenac, are effective in the management of nonspecific low back pain, but their use requires caution due to potential adverse effects 4.
- A study protocol for a randomized controlled trial aimed to assess the effectiveness of paracetamol, diclofenac, and advice for acute low back pain, as well as the additional effectiveness of these treatments compared to advice only 5.
Safety and Side Effects
- The use of diclofenac has been associated with potential side effects, including gastrointestinal disturbances, dizziness, and heart palpitations 2.
- A review of pharmacological treatments for chronic low back pain noted that NSAIDs like diclofenac are not without side effects, and that their use should be carefully considered 3.