Muscle Relaxant Effectiveness in Acute, Atraumatic Low Back Pain

In otherwise healthy adults with acute, atraumatic low back pain, pharmacologic treatment generally consists of non-steroidal anti-inflammatories (NSAID), muscle relaxants, and opiates. Prescribers tend to prescribe either one or some combination of these medications. The side effect profile of these medications can be debilitating. Additionally, in the current opioid crisis, prescribers are moving away from use of opiates. Thus, the efficacy and side effect profile of the two remaining medications should be understood by prescribers. While evidence shows muscle relaxants do provide pain relief in low back pain, clinical trials do not find evidence that muscle relaxants provide any additional pain relief beyond NSAID monotherapy. Additionally, the side effect profile may decrease the tolerability of these medications.