News Author: Laurie Barclay, MD

April 10, 2006 — Omega-3 fatty acid supplements may be effective for relieving neck and low back pain, according to the results of a short-term trial reported in the April issue of Surgical Neurology.

"The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is a well-established effective therapy for both acute and chronic nonspecific neck and back pain," write Joseph Charles Maroon, MD, and Jeffrey W. Bost, PAC, from the University of Pittsburgh Medical Center in Pennsylvania. "Extreme complications, including gastric ulcers, bleeding, myocardial infarction, and even deaths, are associated with their use. An alternative treatment with fewer side effects that also reduces the inflammatory response and thereby reduces pain is believed to be omega-3 essential fatty acids (EFAs) found in fish oil."

From March to June 2004, 250 patients evaluated by a neurosurgeon and found to have nonsurgical neck or back pain were asked to take a total of 1200 mg/day of omega-3 EFAs (eicosapentaenoic acid [EPA] and decosahexaenoic acid [DHA]) found in fish oil supplements. Approximately 1 month after starting the supplement, these patients were sent a questionnaire.

Of the 250 patients, 125 returned the questionnaire. Average duration of fish oil therapy at the time of returning the questionnaire was 75 days. Dosage of EFAs was 1200 mg in 78% and 2400 mg in 22%. Reported benefits were discontinuation of prescription NSAIDs in 59% of patients, improvement in overall pain in 60%, improvement in joint pain in 60%, and satisfaction with the level of improvement in 80%. There were no significant adverse effects reported, and 88% stated they would continue to take the fish oil supplements.

"Our results mirror other controlled studies that compared ibuprofen and omega-3 EFAs demonstrating equivalent effect in reducing arthritic pain," the authors write. "Omega-3 EFA fish oil supplements appear to be a safer alternative to NSAIDs for treatment of nonsurgical neck or back pain in this selective group."

Study limitations include retrospective, non–placebo-controlled survey design; variability in underlying patient pathology; and lack of long-term follow-up.

"That close to two thirds of patients could discontinue NSAIDs is certainly provocative, especially given the recent FDA [Food and Drug Administration] warnings regarding their complications," the authors write. "The effectiveness of omega-3 EFAs in rheumatoid and some cases of osteoarthritis has been demonstrated. Appropriately designed studies are needed to confirm the effectiveness of omega-3 EFA for pain relief in discogenic pain."