Expert Opinion on the Use of Analgesics for the Management of Cervical Spondylosis and Low Back Pain in Real-World Indian Settings

Abstract

Objective: The present survey-based study aims to gather clinicians' opinions regarding the use of analgesics, for the management of cervical spondylosis (CS) and low back pain (LBP) in Indian settings, both as mono and combination therapies. Methodology: The multiple-response questionnaire-based survey, comprising 23 questions, gathered feedback on current practices, clinical observations, and experiences related to the use of analgesics, both as mono and combination therapies, in routine settings. The survey respondents were specialists with expertise in managing CS and LBP. Results: Out of 598 clinicians, 58% preferred the combination of aceclofenac and thiocolchicoside for managing LBP. Approximately 47% of clinicians prescribed this combination to patients aged 30 to 40 years for managing LBP. About 65% of clinicians indicated that the combination of aceclofenac and thiocolchicoside is typically prescribed for more than 5 days. Around 64% of clinicians expressed the opinion that this combination relieves pain within 24 to 48 hours. Notably, about 91% of clinicians reported that they consider both minimal sedation and efficacy as important factors when prescribing muscle relaxants to patients. The majority of clinicians (77.26%) preferred using a combination of aceclofenac and paracetamol to manage arthritic pain. Furthermore, approximately 92% of the respondents stated that aceclofenac is associated with fewer gastrointestinal (GI) side effects. Conclusion: The survey results indicate a strong preference among clinicians for the combination of aceclofenac and thiocolchicoside for managing LBP.  The survey underscores the importance of considering both sedation levels and efficacy when prescribing muscle relaxants and highlights aceclofenac and paracetamol as the preferred combination for managing arthritic pain. Additionally, the clinicians emphasize the lower incidence of gastrointestinal side effects associated with aceclofenac.