Health Day Reporter
Friday, July 9, 2021 (Health Day News)-Although tens of millions of Americans are turning to muscle relaxants to relieve low back pain, a new Australian review found little evidence that such drugs actually work.
This is the conclusion of an in-depth study of 31 previous surveys, which enrolled more than 6,500 patients with low back pain. Enrolled patients have been using 18 different prescription muscle relaxants to treat low back pain.
However, although studies have shown that muscle relaxants may relieve pain in the short term, “on average, the effect may be too small to be important,” said study author James McCauley. “And compared to taking a placebo or sugar pill, most patients will not feel any difference in their pain.”
Another concern is that in addition to being ineffective, “the risk of side effects will also increase,” warned McCauley, director of the Centre for Pain Effects at the School of Health Sciences at the University of New South Wales in Sydney.
In addition to the lingering risk of addiction, such side effects include dizziness, drowsiness, headache, and/or nausea.
McAuley said his team was surprised by these findings, “because early research showed that muscle relaxants can indeed reduce pain intensity. But when we included all the latest research, the results became less certain.”
One problem is that most studies “are not doing very well, which means we can’t be very sure of the results,” Macaulay said.
For example, none of the studies explored long-term use of muscle relaxants. This means that the Australian team can only evaluate the effectiveness of muscle relaxants within two time frames: the entire initial two-week regimen and between 3 and 13 weeks. First, they found little evidence of no significant analgesic effect; in the second case, they found no pain intensity or disability reduction benefits.
McAuley’s conclusion: “It is clear that there is a need to improve the research methods of low back pain so that we can better understand whether drugs can help people.
“Low back pain is very common. 7% of people worldwide experience this condition at any time. Most people, about 80%, will experience low back pain at least once in their lifetime,” Macaulay noted.
But because it is often difficult to find the exact cause, many treatments—including non-steroidal anti-inflammatory drugs, opioids, exercise therapy, and/or counseling—are designed to control pain rather than provide a cure. Macaulay said muscle relaxants — prescribed for 30 million Americans in 2020 — fall into this category.
Given that muscle relaxants can neither cure nor relieve pain, “it is clear that there is a need to develop and test new effective and cost-effective treatments for patients with low back pain,” he said.
At the same time, Macaulay said that actions are being taken to “de-medicalize” the treatment of low back pain by adopting technologies that focus on drugs or surgical alternatives.
For example, “We know that people with low back pain should avoid bedridden,” he pointed out, “They should stay active as much as possible and continue their daily activities, including work, as much as possible.
“Advice and education about low back pain should be provided to people who have recently experienced low back pain,” Macaulay added. “[And] They should be assured that their condition is not serious, and whether or not they take drugs or other treatments, their low back pain is likely to improve over time. “
He and his colleagues reported their findings in the July 7th magazine. BMJ.
“The problem is that there are many reasons for back pain,” said Dr. Daniel Parker, associate professor of orthopedics at the William Beaumont School of Medicine at the University of Oakland in Rochester, Michigan.
Therefore, in terms of treatment, “there is no one size fits all,” Parker emphasized that he is also a spine surgeon at Beaumont Royal Oak Hospital.
However, Park believes that in terms of muscle relaxants, “there may be a short-term benefit that can help patients manage severe pain.”
For example, he suggested that patients with “excessive use of muscle strain” or patients with a herniated disc may benefit from short-term use of muscle relaxants.
But what about patients with degenerative disc degenerative back pain? Not so much.
Park pointed out that regardless of the source of the problem, long-term pain relief is unlikely.
“In the long run, treatment and core strengthening will be more beneficial,” Parker said, and every effort should be made to determine the specific cause and minimize the risk of chronic disease, permanent damage and lasting discomfort.
The National Research on Neurological Diseases and Stroke has more information about back pain.
Source: Dr. James McAuley, Director of the Pain Impact Center, School of Health Sciences, University of New South Wales School of Medicine, Sydney, Australia; Senior Research Scientist, Randwick Neuroscience Research Center, Australia; Daniel Park, MD, Associate Professor of Orthopedics, University of Auckland William Beaumont School of Medicine, Spine surgeon at Beaumont Hospital-Royal Oak, UnaSource Surgery Center, Oakland Regional Hospital, Rochester, Michigan; BMJ, July 7, 2021