Evidence Review

Drug Therapy

Paracetamol, paracetamol-weak opioid compounds, NSAIDs

Muscle relaxants

Strong opioids

Antidepressant Medications

Bed Rest

Advice on Staying Active

Muscle relaxants

Trials of muscle relaxant treatment for patients with acute back pain have used a wide range of agents including diazepam, baclofen and dantrolene.

	Muscle relaxants effectively reduce acute back pain.
	Comparisons of effectiveness between muscle relaxants and NSAIDs are inconsistent. There are no comparisons to paracetamol.
	Muscle relaxants have significant adverse effects including drowsiness and potential physical dependence even after relatively short courses (i.e. one week). Henry et al 1996, Koes et al 1996a, van Tulder et al 1996a