Title: The role of skeletal muscle relaxants in the management of lower back pain in the ED

Category: Orthopedics

Keywords: back pain, muscle relaxants (PubMed Search)

Posted: 11/23/2019 by Brian Corwell, MD

The role of skeletal muscle relaxants in the management of lower back pain in the ED

Patients with lower back pain (LBP) presenting to the ED are often treated with NSAIDs plus skeletal muscle relaxants.

A recent study in Annals of Emergency Medicine compared functional outcomes and pain in ED patients with acute non radicular LBP with 4 different treatment regimens.

Ibuprofen plus placebo
Ibuprofen plus baclofen
Ibuprofen plus metaxalone
Ibuprofen plus tizanidine

Conclusion: Adding a muscle relaxant to ibuprofen did not improve pain or improve function at 1 week following an ED visit for LBP.

Note: Prior studies have found no benefit to adding opioids or diazepam to NSAIDs for ED patients with acute non radicular LBP

References

Friedman et al., 2019. Annals of Emergency Medicine

A Randomized, Placebo-Controlled Trial of Ibuprofen Plus Metaxalone, Tizanidine, or Baclofen for Acute Low Back Pain.