The pills that I am taking for the back pain that started right after Thanksgiving – naproxen – are supposed to help reduce the pain and the inflammation. Years ago, when naproxen was still available only by prescription, my doctor had me take it, and it seemed to work then. I got better then and I am getting better now too.
Is it the naproxen that makes me better? Or would I be getting better anyway?
What if I had an identical twin and we both had back pain and just one of us took naproxen and one of us got better and the other didn’t? Even that wouldn’t prove anything, because those of us who are human are complex and subject to all sorts of environmental differences.
That’s the trouble with anecdotal evidence. What works for one person might not do anything for someone else. We need a better way of figuring out what pills to take for what conditions.
There is a better way, and it is a clinical trial. But what are the standards to which we should hold all clinical trials?
Unfortunately, many people – even those in the medical profession – don’t know or care. The double-blind placebo-controlled trial is one of the major scientific advances of the 20th century, with far greater consequences than are generally understood. Steven Bratman, M.D., has written clearly and fully on this important subject and authorized me to make it available on my website.
When they say that a study is double-blind it means that neither the researcher nor the participants know if they are getting the real thing or a fake treatment or placebo. Double-blind trials, particularly if they include many people, are the best way we know to judge a treatment.
Any time you see someone suggesting that you take this or that pill for your diabetes or anything else it makes sense to see if they work. So I checked up on the naproxen that I’m taking.
When I searched the professional literature for the words naproxen and back, I found 42 studies. At least one of these was double-blind and placebo-controlled. Since it had only 37 patients, you can’t call it large-scale, but naproxen was clearly better than a placebo and another pain reliever called diflunisal.
Serendipitously, I found another study that indicated I might even do better with a prescription muscle relaxant (cyclobenzaprine). I can’t be sure if it will work, however, because this was an “open-label” trial. This means that both the researcher and the participant knew the treatment that the participant received.
If my back doesn’t get better in the next couple of days, I guess I will have to see my doctor for a muscle relaxant or something else. Meanwhile, I’ll keep taking my naproxen until the pain goes away. And if I am ever tempted to take some other treatment for my diabetes, I’ll make sure that it has been subjected to a double-blind trial.