Myorelaxants, NSAIDs, NSAID-Acetaminophen Combo Ease Lower Back Pain

No improvement seen in lower back pain with acetaminophen alone or placebo across trials

HealthDay News — For adults with acute lower back pain (LBP), myorelaxants, nonsteroidal anti-inflammatory drugs (NSAIDS), and NSAIDs combined with acetaminophen can reduce pain and disability, according to a review published online February 22 in the Journal of Orthopaedic Research.

Alice Baroncini, MD, PhD, from RWTH University Hospital in Aachen, Germany, and colleagues conducted a systematic review to examine whether pharmacological management of acute LBP can effectively reduce pain and disability and which drugs have the highest efficacy. All randomized controlled trials examining the efficacy of myorelaxants, NSAIDs, and acetaminophen for acute (less than 12 weeks) LBP of the lumbar spine in adults were included; studies assessing opioid use in acute LBP were not included. Data were obtained from 18 trials with 3478 patients.

The researchers found that at approximately one week, myorelaxants and NSAIDs were effective for reducing pain and disability in acute LBP. Greater improvement was seen with the combination of NSAIDs and acetaminophen than with NSAIDs alone, while no significant improvement was seen with acetaminophen alone. Placebo was not effective for pain reduction.

“This is a first step towards the optimization of the management of acute low back pain. However, specific patient characteristics such as having allergies and comorbidities must always be taken into consideration,” Baroncini said in a statement. “Further research will need to focus on the identification of the type of drugs that not only offer the best and quickest pain relief, but also show the lowest rate of symptom recurrence.”

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