Low back pain (LBP) is one of the most common musculoskeletal disorders and a leading cause of disability worldwide. It affects individuals across all age groups and is responsible for significant socioeconomic burden due to reduced productivity and increased healthcare utilization. Epidemiological studies suggest that nearly 60–80% of individuals experience at least one episode of low back pain during their lifetime, making it a major public health concern [1]. The etiology of low back pain is multifactorial, including mechanical strain, intervertebral disc degeneration, ligamentous injury, and postural abnormalities. In most cases, it is classified as nonspecific low back pain, where no definitive structural cause can be identified. Pain and restricted mobility are the primary clinical features, often leading to limitations in daily activities and reduced quality of life [2]. Pharmacological management plays a crucial role in the treatment of low back pain, particularly in the acute and subacute phases. Among the available treatment options, nonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed due to their effectiveness in reducing inflammation and alleviating pain. Common NSAIDs such as Ibuprofen, Diclofenac, and Naproxen are frequently used in clinical practice. NSAIDs exert their therapeutic effects by inhibiting cyclooxygenase (COX) enzymes, which are involved in the synthesis of prostaglandins—key mediators of inflammation and pain. By reducing prostaglandin production, NSAIDs help decrease inflammation, relieve pain, and improve functional capacity. However, their use must be carefully balanced against potential adverse effects such as gastrointestinal irritation, renal dysfunction, and cardiovascular risks [3]. While the analgesic efficacy of NSAIDs in low back pain has been well established, their role in improving functional outcomes such as mobility and physical performance is equally important. Pain relief alone may not fully restore a patient’s ability to perform daily activities; therefore, assessment of mobility provides a more comprehensive measure of treatment success. Functional improvement is particularly relevant in clinical settings, as it directly impacts patient independence and quality of life [4]. Several clinical guidelines recommend NSAIDs as first-line pharmacological therapy for low back pain due to their favorable efficacy profile. However, variations in patient response, drug selection, and dosing strategies necessitate further evaluation of their overall effectiveness in real-world clinical settings [5]. Understanding both the benefits and limitations of NSAID therapy is essential for optimizing patient care. In this context, the present study aims to evaluate the efficacy of NSAIDs in reducing pain and improving mobility in patients with low back pain, thereby providing a comprehensive assessment of their therapeutic role.

Study Design and Setting This was a prospective observational study conducted in collaboration between the Department of Orthopedics and the Department of Pharmacology at a tertiary care teaching hospital. The Orthopedics department was responsible for clinical evaluation and diagnosis, while the Pharmacology department contributed to drug selection, dose optimization, and monitoring of therapeutic response and safety. Study Duration The study was carried out over a period of 6 months Study Population The study population included patients presenting with complaints of low back pain to the outpatient and inpatient services of the Orthopedics department during the study period. Sample Size A total of 120 patients who met the inclusion criteria were enrolled consecutively during the study period. Inclusion Criteria • Patients aged between 18 and 65 years • Patients diagnosed with acute or subacute low back pain (duration <12 weeks) • Patients willing to participate and comply with follow-up Exclusion Criteria • Chronic low back pain (>12 weeks) • History of spinal trauma, surgery, or malignancy • Known hypersensitivity to NSAIDs • Peptic ulcer disease, renal impairment, or cardiovascular disorders • Pregnant or lactating women Data Collection Procedure Data were collected using a structured case record form. Each patient underwent detailed evaluation at baseline and follow-up. The following information was recorded: • Demographic details: age, gender • Clinical assessment: duration and severity of pain • Drug details: type, dose, and duration of NSAID therapy • Pain assessment: using Visual Analog Scale (VAS) • Mobility assessment: using a standardized functional mobility score Clinical evaluation was performed by the Orthopedics department, while pharmacological evaluation, including drug appropriateness and safety monitoring, was carried out by the Pharmacology department. Intervention Patients were prescribed NSAIDs such as: • Ibuprofen • Diclofenac • Naproxen The choice of drug, dosage, and duration (typically 5–10 days) were based on standard treatment guidelines and individualized patient assessment. Follow-up Patients were evaluated at: • Baseline (Day 0) • Follow-up (Day 7–10) Pain and mobility scores were reassessed to evaluate treatment efficacy. Adverse drug reactions, if any, were also monitored and recorded. Statistical Analysis: Data were entered into Microsoft Excel and analyzed using SPSS version 20.0. Continuous variables were expressed as mean ± SD and Categorical variables as frequency and percentage. Paired t-test was used for comparison of pre- and post-treatment values. p-value < 0.05 considered statistically significant Ethical Considerations: Approval was obtained from the Institutional Ethics Committee and Written informed consent was obtained from all participants.

A total of 120 patients with low back pain were included in the study. The majority of patients were in the age group of 31–50 years, with a mean age of 38.4 ± 9.2 years. Males constituted a slightly higher proportion compared to females. Table 1: Demographic Characteristics of Study Participants (n = 120) Variable Category Number (n) Percentage (%) Age (years) Mean ± SD 38.4 ± 9.2 — Gender Male 68 56.7% Female 52 43.3% There was a statistically significant reduction in pain scores following NSAID therapy. The mean VAS score decreased from 7.2 ± 1.1 before treatment to 3.8 ± 1.0 after treatment (p < 0.001), indicating effective pain relief. Table 2: Comparison of Pain Scores (VAS) Parameter Mean ± SD p-value Pre-treatment 7.2 ± 1.1 < 0.001 Post-treatment 3.8 ± 1.0 Functional mobility showed significant improvement following NSAID therapy. The mean mobility score increased from 4.5 ± 1.2 before treatment to 7.1 ± 1.3 after treatment, which was statistically significant (p < 0.001). Table 3: Comparison of Mobility Scores Parameter Mean ± SD p-value Before treatment 4.5 ± 1.2 < 0.001 After treatment 7.1 ± 1.3 A small proportion of patients experienced mild adverse drug reactions, most commonly gastrointestinal discomfort. No serious adverse events were reported. Table 4: Adverse Drug Reactions Observed ADR Number (n) Percentage (%) Gastric irritation 12 10% Nausea 6 5% No ADR 102 85%

Low back pain (LBP) is a major contributor to disability and functional limitation worldwide, significantly affecting quality of life and work productivity. The present study evaluated the efficacy of NSAIDs in reducing pain and improving mobility in patients with low back pain and demonstrated a statistically significant improvement in both outcomes following treatment. In this study, a marked reduction in pain scores was observed after NSAID therapy, with mean VAS scores decreasing significantly from baseline to follow-up (p < 0.001). This finding is consistent with previous studies that have established NSAIDs as effective agents for the management of acute and subacute low back pain [6]. NSAIDs exert their analgesic effect primarily through inhibition of cyclooxygenase (COX) enzymes, leading to decreased synthesis of prostaglandins, which play a key role in inflammation and pain perception [7]. In addition to pain relief, the present study demonstrated a significant improvement in functional mobility among patients receiving NSAIDs. This is an important clinical outcome, as restoration of mobility directly influences a patient’s ability to perform daily activities and improves overall quality of life. Similar findings have been reported in earlier studies, which indicate that reduction in pain intensity is closely associated with improved physical function and mobility [8]. The results of this study also highlight the importance of early pharmacological intervention in low back pain. Timely administration of NSAIDs can prevent progression of pain, reduce muscle spasm, and facilitate early mobilization. Early mobilization is known to reduce the risk of chronicity and long-term disability associated with low back pain [9]. Another important observation in this study was the relatively low incidence of adverse drug reactions (ADRs), with most being mild and limited to gastrointestinal symptoms. This aligns with existing literature, which suggests that short-term use of NSAIDs is generally safe when prescribed appropriately and monitored carefully [10]. However, the potential for gastrointestinal, renal, and cardiovascular side effects necessitates cautious use, especially in high-risk patients. The findings of this study support current clinical guidelines that recommend NSAIDs as first-line pharmacological therapy for low back pain. However, variability in patient response and risk of adverse effects underline the importance of individualized treatment. Appropriate drug selection, dosing, and duration of therapy are essential to maximize benefits while minimizing risks [11].

NSAIDs are effective in significantly reducing pain and improving mobility in patients with low back pain. Their short-term use provides substantial symptomatic relief with a low incidence of mild adverse effects. These findings support their role as first-line therapy, while emphasizing the importance of appropriate selection and monitoring to ensure safe and effective treatment.

1. Deyo RA, Weinstein JN. Low back pain. N Engl J Med. 2001;344:363–370. 2. van Tulder M, Becker A, Bekkering T, et al. European guidelines for low back pain. Eur Spine J. 2006;15(Suppl 2):S169–S191. 3. Chou R, Huffman LH. Medications for acute and chronic low back pain. Ann Intern Med. 2007;147(7):505–514. 4. Roelofs PD, Deyo RA, Koes BW, et al. Nonsteroidal anti-inflammatory drugs for low back pain. Cochrane Database Syst Rev. 2008;CD000396. 5. Katz WA. Musculoskeletal pain and its socioeconomic implications. Clin Rheumatol. 2002;21:S2–S4. 6. Roelofs PD, Deyo RA, Koes BW, et al. Nonsteroidal anti-inflammatory drugs for low back pain. Cochrane Database Syst Rev. 2008;CD000396. 7. Vane JR, Botting RM. Mechanism of action of anti-inflammatory drugs. Int J Tissue React. 1998;20(1):3–15. 8. Hayden JA, van Tulder MW, Malmivaara A, et al. Exercise therapy for low back pain. Ann Intern Med. 2005;142(9):765–775. 9. Waddell G. The Back Pain Revolution. 2nd ed. Edinburgh: Churchill Livingstone; 2004. 10. Laine L. Approaches to nonsteroidal anti-inflammatory drug use in the high-risk patient. Gastroenterology. 2001;120(3):594–606. 11. Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: joint clinical practice guideline. Ann Intern Med. 2007;147(7):478–491.