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Despite a lack of evidence of efficacy, skeletal muscle relaxants are commonly used to treat back pain in conjunction with nonsteroidal anti-inflammatory drugs (NSAIDs). Researchers at two emergency departments in the Bronx evaluated three muscle relaxants in a randomized, double-blind trial. A total of 320 patients received either placebo or one of the three study drugs (baclofen, 10–20 mg; metaxalone, 400–800 mg; or tizanidine, 2–4 mg) in addition to ibuprofen (600 mg) every 8 hours for 7 days. The median functional disability score at baseline was 19 on a validated 24-item scale.
At 1 week, there was no significant difference between groups in the primary outcome — improvement in functional disability score (mean improvement, about 11 poi…