Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Salicylates, including compounds such as methyl salicylate and salicylic acid, have a well-established scientific basis for use in the management of backache, particularly as topical analgesics. The primary mechanism involves the inhibition of cyclooxygenase (COX) enzymes, leading to reduced synthesis of prostaglandins, which are mediators of inflammation and pain. Topical salicylates, such as those found in creams, gels, or patches (e.g., methyl salicylate), are absorbed through the skin and act locally to relieve musculoskeletal pain, including backache.

Multiple clinical trials and systematic reviews have demonstrated that topical salicylates can provide modest but statistically significant pain relief for acute musculoskeletal pain conditions, including back pain, compared to placebo. While the effect size may be less than that of oral NSAIDs, topical salicylates are associated with fewer systemic side effects, making them attractive for localized pain. Guidelines from organizations such as the American College of Physicians recognize topical NSAIDs and salicylates as reasonable first-line options for patients with non-specific back pain, especially when oral medications are contraindicated.

It is important to note that the evidence is strongest for short-term relief of mild to moderate pain. There is limited data on their effectiveness for chronic or severe back pain. Nonetheless, the scientific consensus supports their use as part of a multimodal approach to backache management, particularly for those seeking non-systemic therapies.

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