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Muscle relaxant drugs are effective in managing non-specific low-back pain. But because they can have troublesome side effects, they should be used with caution.
"Controversies surrounding muscle relaxants have resulted in some resistance to their use in patient care," says Dr. Maurits van Tulder of Amsterdam's Vrije University Medical Centre. "So we carried out a carefully designed systematic review of the literature looking at the existing evidence for or against muscle relaxants in the treatment of non-specific low-back pain."
Non-specific low-back pain (LBP) was defined as pain between the shoulder blades and buttocks that did or did not radiate down towards the knees and that was not caused by an infection, tumour, fracture or other underlying disorder.
For years, doctors have debated using muscle relaxants for LBP because these drugs are known to cause side effects, including drowsiness, headache, blurred vision, nausea and vomiting.
Even so, the use of muscle relaxants, including tranquilizers and certain anti-spasticity drugs, is widespread. One previous study found 91 per cent of physicians reported prescribing muscle relaxants for patients with LBP. Another found that 35 per cent of patients visiting a primary care physician for LBP had received a prescription for a muscle relaxant.
After carefully reviewing 30 double-blinded controlled trials, the researchers came to the following conclusions:
- Muscle relaxants are effective for short-term relief of back pain in patients with either acute and chronic LBP.
- There was no evidence when taking an adequate dose that any one muscle-relaxing drug was better than another.
- The incidence of drowsiness, dizziness and other side effects was the same for all the drugs reviewed. Combining muscle relaxants with pain killers or non-steroidal anti-inflammatory drugs speeded recovery, but increased the risk for drowsiness and dizziness.
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