Muscle Relaxants: Overuse, and Ineffective for Acute Low Back Pain


Low back pain is the most common cause of limited or restricted activity in people younger than age 45, and one of the most common reasons for visiting a physician.  To treat back pain, doctors often prescribe a range of medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants and analgesics.  Muscle relaxants are the second most common type of drug used to treat low back pain; a 1998 study found that on average, 35% of people with low back pain are prescribed some type of muscle relaxant.


The use and overall efficacy of muscle relaxants for low back pain remain subjects of debate.  In 1994, the Agency for Health Care Policy and Research determined that muscle relaxants were no more effective than NSAIDs, and only “probably” more effective than placebo medications, in the treatment of acute (new or severe) low back pain.  In addition, because muscle relaxants have sedative properties, they can contribute to other negative side-effects, including drowsiness and increased risk of falls, and can impair one’s ability to drive or operate machinery.


In a recent issue of Spine, researchers examined the use of muscle relaxants among a cohort population of more than 1,600 individuals who sought a health care provider for relief of low back pain, the drugs did not help patients return to normal functioning more quickly than patients not taking muscle relaxants, and in fact, were associated with an increase in the time it took for patients to recover from pain.


“This large cohort study showed no evidence of benefit, and even a delay in functional recovery, for severely affected patients who take muscle relaxants in the setting of acute back pain,” the authors concluded.  They added that “ a better understanding” of the clinical effects of muscle relaxants in low back patients is needed, and that randomized, community-based trials should be conducted to determine whether muscle relaxants provide any real benefit in addition to standard low back pain care.

 Although chiropractic is much more than a “treatment” for low back pain, it is quick and effective in eliminating pain and restoring function, plus there are no side-effects.




 1.         Cherkin DC, Wheeler KJ, Barlow W, et al.  Medication use for low back pain in primary care.  Spine 1998; 23:6-7-14

 2.         Verbrugge LM, Patrick DL.  Seven chronic conditions: their impact on U.S. adults’ activity levels and use of medical services.  American Journal of Public Health 1995; 85: 173-82

 3.         Berstein E, Carey TS, Mills Garrett J.  The use of muscle relaxant medication in acute low back pain.  Spine 2004; 29 (12); 1346-51

 4.         Dynamic Chiropractic October 2004 article by Dr. Michael Devitt

Yours in health,

Lynne Sullivan D.C.

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