Benefit, Safety of Muscle Relaxants for Low Back Pain Uncertain

THURSDAY, July 8, 2021 (HealthDay News) — Considerable uncertainty exists about the clinical efficacy and safety of muscle relaxants for the treatment of low back pain, according to the results of a systematic review and meta-analysis published online July 7 in The BMJ.

Aidan G. Cashin, from the Centre for Pain IMPACT at Neuroscience Research Australia in Sydney, and colleagues conducted a literature review to assess the efficacy, acceptability, and safety of muscle relaxants for low back pain.

Based on a meta-analysis of data from 31 of 49 identified studies (6,505 participants), the researchers found that for acute low back pain, very low-certainty evidence showed that at two weeks or less, nonbenzodiazepine antispasmodics were associated with a reduction in pain intensity versus control (mean difference −7.7, 95 percent confidence interval [CI], −12.1 to −3.3) but not a reduction in disability (−3.3; 95 percent CI, −7.3 to 0.7). Compared with control for acute low back pain, low and very low-certainty evidence showed that nonbenzodiazepine antispasmodics might increase the risk for an adverse event (relative risk, 1.6; 95 percent CI, 1.2 to 2.0) but might have little to no effect on acceptability (relative risk, 0.8; 95 percent CI, 0.6 to 1.1).

“Large, high-quality, placebo controlled trials are urgently needed to resolve uncertainties about the efficacy and safety of muscle relaxants for low back pain,” the authors write.

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