Omega 3 for Neck or Back Pain

Summarized by Robert W. Griffith, MD
May 22, 2006

Summary

Omega 3 supplements are able to relieve chronic neck and chronic low back pain according to a new study.

Introduction

Neck pain and low back pain without obvious serious cause are best treated with nonsteroidal anti-inflammatory drugs (NSAIDs), along with appropriate physical measures - heat, cold, exercise, etc. Over 70 million prescriptions are written for NSAIDs each year in the USA, and 30 billion over-the-counter tablets are sold annually. They have their drawbacks, however: gastric irritation or other minor side effects are reported in up to 50% of users, while more serious ones - excessive bleeding, heart attack - occur much less frequently.

Obviously, any treatment that is free of side effects would be welcome, if it can be shown to be as effective as available drugs. In a recent study the effectiveness of omega 3 essential fatty acids have been tested; the results have been published in the journal Surgical Neurology, and we summarize them here.

What was done

A neurosurgeon evaluated 250 patients with nonsurgical spine pain - the majority had degenerative disc disease with facet arthropathy in the lumbar or cervical spine. They were all taking NSAIDs, with three-quarters of them on COX-2 inhibitors.

All the patients were asked to take pharmaceutical-grade omega 3 fatty acids at a dose of 2.4 grams daily for 2 weeks, followed by 1.2 grams daily. The supplements - Nordic Naturals ProEPA^®/EPA^® - contained eicosopentaenoic acid and decosahexaenoic acid. The patients were asked to taper off their NSAIDs for 1 to 2 weeks after the first 2 weeks on the supplements.

One month after starting the fish oil supplements the participants were mailed a questionnaire about their symptoms.

The results

Of the 250 patients, just half returned the questionnaire. They had been taking the fish oil for an average of 75 days. Three-quarters of them were taking 1.2 grams, and the rest 2.4 grams daily.

Sixty percent of the respondents said they had stopped taking their NSAID for control of pain, and 60% said their overall pain was improved compared with how it was before starting the supplements. Eighty percent of the subjects stated that they were satisfied with the improvement in their pain, and 88% said they would continue to take omega 3 supplements.

No significant side effects were reported, except for loose bowel movements in two cases.

What these findings may mean

There are scientific reasons for why fish oil supplements should work in these patients. In disc disease there is marked inflammatory reaction at the site of the herniated lumbar discs, according to Dr Maroon, one of the authors of the study. "The inflammatory cytokines interleukin-1 alpha, interleukin-6 and tissue necrosis factor-alpha are routinely found at the site of disc rupture and markedly enhance arachidonic acid, which is known to cause pain," he said. "Omega 3 fatty acids limit the release of arachidonic acid and pro-inflammatory prostaglandin."

However, we should not accept this study as evidence that omega 3 fatty acids will always work in this condition. The study was uncontrolled, and only half the participants provided any feedback. It merely serves to lay the groundwork for a well-controlled, double-blind study, comparing the effectiveness of the supplements with either an NSAID, or placebo, or (best) both.

Future studies should be done by independent investigators (both authors of the present study are principals of a company, Inflammation Solutions, Inc., which markets Nordic Naturals essential fatty acids).

As we said at the start of this article, there are plenty of reasons to ensure your intake of omega 3s is high enough. Most people can readily achieve this by a sensible diet - plenty of fish, tofu and other forms of soybeans, canola, walnut and flaxseed, and their oils. Some people may need to take supplements. We can only advise that high quality products are chosen, with guaranteed content uniformity. Such supplements may be tried in chronic neck or back pain, without risk of serious side effects.

Source

• Omega-3 fatty acids (fish-oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. JC. Maroon, JW. Bost, Surg Neurology, 2006, vol. 65, pp. 326--331

Related Links
Essential fatty acids
American Heart Association: Fish and Omega-3 Fatty Acids
Whole Health Foods: Omega-3 fatty acids

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