For patients with acute, low back pain presenting to the emergency department, neither naproxen + oxycodone/acetaminophen or naproxen + cyclobenzaprine provided better pain relief or improvement than naproxen + placebo, a recent study published in JAMA has shown.
Patients presenting with low back pain are typically treated with a combination of NSAIDS, acetaminophen, opioids, or skeletal muscle relaxants. However, pain outcomes are generally low. Benjamin W. Friedman, MD, MS, of the Montefiore Medical Center, and colleagues randomized 323 patients with non-traumatic, non-radicular low back pain of ≤2 weeks duration to receive a 10-day course of naproxen + placebo, naproxen + cyclobenzaprine 5mg, or naproxen + oxycodone/acetaminophen (5mg/325mg). Study patients were also given a standardized 10-minute low back pain educational session prior to discharge.
Data showed that neither naproxen + oxycodone/acetaminophen or naproxen + cyclobenzaprine provided better relief or functional outcomes than naproxen + placebo. Specifically, measures of pain, functional impairment, and use of healthcare resources did not differ between the study groups at 7 days or 3 months post emergency department visit.
Overall, nearly two-thirds of patients showed clinically significant improvement of low back pain and function 1 week later. Forty percent of the group reported moderate or severe pain, and half reported functionally impairing low back pain, and nearly 60% were still using medication for their low back pain 1 week later. In addition, <3% of patients reported using an opioid within the previous 72 hours at 3 months post emergency department visit.
Researchers concluded that study findings do not support the use of these additional drugs in this setting.
For more information visit JAMAnetwork.com.