Should We Add Muscle Relaxants to Ibuprofen for Acute Low Back Pain?

A high-quality study of three muscle relaxants confirms what most of us already know: They don't help.

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…

Reviewing Author

Benton R. Hunter, MD

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Chair, Evidence Based Healthcare Interest Group)

Benton R. Hunter, MD

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Chair, Evidence Based Healthcare Interest Group)

Should We Add Muscle Relaxants to Ibuprofen for Acute Low Back Pain?

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Reviewing Author