A recent study has shown that there is no short-term extra benefit when muscle relaxants are added to ibuprofen (i.e. Advil) for acute low back pain.
Government-funded (US) researchers wanted to know if treatment for acute low back pain - of 2 weeks' duration or less (average 72 hours) - was more effective with a combination of ibuprofen and a muscle relaxant as compared with ibuprofen alone to improve functional outcomes and reduce pain. They enrolled 320 patients who presented to 1 of 2 emergency departments with complaint of low back pain, not involving spinal nerves.
All patients were given ibuprofen 600 mg to be taken up to 3 times a day, as needed. They were also randomized, concealed allocation unknown, to receive identical-appearing capsules containing placebo, baclofen 10 mg, metaxalone 400 mg, or tizanidine 2 mg, and were instructed to take 1 or 2 capsules up to 3 times a day, as needed. One week later, approximately 34% of patients across the groups reported moderate to severe back pain.
Bottom line
Adding a muscle relaxant to treatment with ibuprofen does not improve functional outcomes or pain, or lessen the number of people reporting moderate to severe back pain one week after starting treatment.
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