Little Evidence That Muscle Relaxants Work for Low Back Pain

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Little Evidence That Muscle Relaxants Work for Low Back Pain

Muscle relaxants, despite being widely prescribed for patients with low back pain, are not very effective, a new study suggests.

A review and meta-analysis of 49 earlier studies found low-certainty evidence that non-benzodiazepine antispasmodics were associated with a small reduction in pain intensity but not a reduction in disability. Low- and very low-certainty evidence showed that the medications might increase the risk of an adverse event, according to the report published in The BMJ.

“Our research study shows that on average, muscle relaxants provide only a small, non-clinically important reduction in acute low back pain,” said lead author Aidan Cashin, a researcher at Neuroscience Research Australia and the University of New South Wales. “That being said, the research is mostly poor quality and some muscle relaxants, particularly non-benzodiazepine antispasmodic medicines, may improve pain for some people. Large, high quality research is urgently needed to resolve uncertainties around the efficacy and safety of these medicines for low back pain.”

These medications aren’t meant to cure low back pain, Cashin said in an email.

“For most people it is very difficult to know with any certainty what is causing low back pain, and therefore many treatments try to provide pain relief rather than try to fix what might be causing the pain,” he added. “Muscle relaxants are commonly prescribed to reduce pain, not to cure whatever is causing the pain.”

Regardless, it’s important to remind patients with low back pain that they shouldn’t take too much time off because of their painful backs, Cashin said. “No matter what medicines people with low back pain are taking, they should avoid staying in bed, and they should try to be active and continue with their usual activities, including work, as much as they can. [This is how we handle back problems in our office – Dr. Lane] High quality research shows that people who do this are more likely to recover faster and more completely.”

SOURCE: https://bit.ly/3wsyJJG The BMJ, online July 7, 2021.

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