Central muscle relaxants: role and place in the treatment of back pain

December 21, 2021
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Back pain is a condition that ranks first in the structure of pain syndromes and remains one of the most actual problems in medicine. In clinical practice, different pathophysiological variants of pain syndromes are often combined, which complicates the choice of optimal treatment.

Objective: to update information on the effectiveness and safety of central muscle relaxants (CMR) in the treatment of back pain, including tizanidine.

Object and methods of research: analysis of relevant sources of information on the effectiveness and safety of CMR, including tizanidine, in the treatment of back pain.

Results. To date, non-steroidal anti-inflammatory drugs (NSAIDs) and CMR have a high level of evidence for non-specific back pain among drugs. The main approaches to the use of CMR for back pain, as determined by clinical guidelines: clinical data do not confirm the superiority of one CMR over another in musculoskeletal system diseases; CMR are not considered first-line therapy in musculoskeletal diseases; in acute back pain as an adjunct therapy can be used CMR; in acute back pain, CMR should be used for a short time (2 weeks).

Conclusions. The results of the analysis of clinical trials in combination with the accumulated experience of clinical use confirm the effectiveness of CMR for the treatment of painful spasms, in particular for back pain. Among the existing CMR, tizanidine is an effective drug with an optimal safety profile, with the possibility of combined use with NSAIDs and the ability to reduce their gastrotoxicity.

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