Simple Solutions for Lower Back Pain Work Best: Study

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Feb. 3, 2023 – Good news for those of us with lower back pain: Muscle relaxants and common pain relievers provided relief from low back pain after a week of treatment, according to a new study of more than 3,000 people.

Acute lower back pain is a common cause of disability worldwide, and often interferes with daily living. the study authors wrote. However, concerns about opioids have prompted more research into other options for pain management. 

In an analysis published in the Journal of Orthopaedic Research, a team of investigators from Germany examined which non-opioid drugs are best for treating it.

The researchers found 18 studies totaling 3,478 patients with acute low back pain that lasted less than 12 weeks. The average age of the patients across all the studies was 42.5 years, and 54% were women. The average length of symptoms before treatment was 15.1 days.

Overall, muscle relaxants and common pain relievers, known as non-steroidal anti-inflammatory drugs – or NSAIDs -- helped reduce pain and disability after about 1 week of use. 

Ibuprofen, aspirin and naproxen are all NSAIDs.

In addition, studies of a combination of these drugs and acetaminophen showed more improvement than NSAIDs alone, but acetaminophen alone had no significant impact on LBP. 

Most patients with acute lower back pain recover on their own, so it is difficult to tell how effective the medications are, the researchers wrote 

However, it is important that other therapies that don’t include medication, are tried first, the researchers said. 

More research is needed to see if the drugs help prevent back from returning, they said. 

Study Supports Opioid Alternatives

The study highlights effective alternatives to opioids for back pain management, Suman Pal, specialist in hospital medicine at the University of New Mexico, says. 

Pal says he was not surprised by the results. “The findings of the study mirror prior studies,” he says. “However, the lack of benefit of paracetamol (acetaminophen) alone needs to be highlighted as important to clinical practice.”  

The main message from the study, says Pal, is that “patients with low back pain should talk to their doctors about the best approach to treatment. 

During those conversations, patients should discuss their symptoms, previous medical conditions, and medications they are currently taking, Pal says. “These factors should guide the choice of pharmacological therapy, if needed.” 

However, more research is needed to better identify which patients would get the  most benefit from NSAIDs and muscle relaxants to manage their pain since chronic NSAID use carries its own potential for side effects, Pal says.