HealthDay News — Disease-modifying antirheumatic drugs (DMARDs) may be underutilized for treatment of low back pain, according to a review published online June 1 in Pain Practice.

Khalid M. Malik, MD, from Northwestern University in Chicago, and colleagues reviewed the literature to determine the role of DMARDs in the treatment of low back pain.

The researchers found that current DMARD use for low back pain is limited in scope and is characterized by isolated use and empiric selection of drugs from a range of available DMARDs. Arbitrary selection characterizes the dose, frequency and route of drug administration — a deviation from treatment protocols proposed for the management of other inflammatory conditions.

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The published literature in this area is of low quality, either prohibiting conclusive results or demonstrating only short-term efficacy of these medications.

“Based on the findings of this review, we recommend that the future DMARD use for [low back pain] is initially limited to patients with debilitating disease who are unresponsive to conventional treatments,” the researchers wrote.

“When used for treatment of [low back pain], combination systemic DMARD therapy should be based on a protocol driven approach already in place for other chronic inflammatory conditions.”


  1. Malik KM et al. Pain Pract. 2015; doi: 10.1111/papr.12323.