In the late 1990s, Cox-2 inhibitors, a newer NSAID, were introduced to provide an analgesic effect for moderate to severe musculoskeletal pain, without the side effects on the GI tract. In 2004, two Cox-2 inhibiting drugs were pulled off the market due to the identification of probable lethal side effects affecting the cardiovascular system.
Cox-2 inhibitors have been used for pain relief and to reduce inflammation. Cox-2 inhibitors have approximately the same pain relieving effects as the older NSAIDs.
In 2004, a study in Spine Journal reported that around 10% of all prescriptions issued were for Cox-2 inhibitors. Currently there is no official standard of care for alternatives to Cox-2 inhibitors.
1 Luo, X, Pietrobon, R, Curtis, L.H., Hey, L.A. Prescription of nonsteroidal anti-inflammatory drugs and muscle relaxants for back pain in the United States. Spine. 2004 Dec. 1.
2 Schnitzer TJ, Ferraro A, Hunsche E, Kong SX. A comprehensive review of clinical trials on the efficacy and safety of drugs for the treatment of low back pain.. J Pain Symptom Manage July 2004.