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Although muscle relaxants are often prescribed for acute low back pain, they do not appear to speed recovery of function

Use of muscle relaxants is very common among patients suffering from acute low back pain. Yet they do not appear to speed recovery of function, according to the findings of a recent study that was supported by the Agency for Healthcare Research and Quality (HS06664). Seventy-eight percent of all 1,633 adults enrolled in the study used nonsteroidal antiinflammatory drugs (NSAIDS), and 49 percent used muscle relaxants at some point during the study.

Among patients seen initially by physicians (versus chiropractors), 64 percent used muscle relaxants. Patients who used muscle relaxants took 19 percent longer to reach functional recovery as those who did not, after controlling for initial functional impairment, age, use of NSAIDs, and other factors.

Slower functional recovery among those taking muscle relaxants could be related directly to the medications. On the other hand, it could be due to factors indirectly related to muscle relaxant use that were not measured, such as greater time spent in bed after the injury or subtly worse prognosis in the group receiving muscle relaxants, according to Timothy S. Carey, M.D., M.P.H., of the Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.

Dr. Carey and his colleagues, whose work was supported by the Agency for Healthcare Research and Quality (HS06664), analyzed pain, functional status, medication use, health care use, and satisfaction with care for low back pain among the patients at baseline and at 2, 4, 8, 12, and 24 weeks. Of the 95 percent of patients who said they returned to their baseline functioning during the 6-month study period, the mean time to functional recovery was 16.2 days, with a median recovery time of 8 days from their initial visit.

See "The use of muscle relaxant medications in acute low back pain," by Eric Bernstein, M.D., M.P.H., Dr. Carey, and Joanne Mills Garrett, Ph.D., in the June 2004 Spine 29(12), pp. 1346-1351.

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