Pain reliever combinations in treatment of patients with acute musculoskeletal back pain

Objective: to compare the clinical efficacy of complex therapy, including a combination of a nonsteroidal anti-inflammatory drug (NSAID) with a muscle relaxant and B vitamins in acute musculoskeletal back pain (MSBP).

Patients and methods. We enrolled 66 patients with acute MSBP, 27 men and 39 women, mean age – 52.8 [29.4; 68.8] years. All patients had different pain localization: 36 (54.5%) – lumbodynia, 22 (33.3%) – cervicodynia, 8 (12.2%) –  thoracodynia. Visual analog scale (VAS) was used to assess pain intensity. Patients in the 1st group (n=32) were prescribed with complex therapy, including Russian drugs meloxicam (Amelotex 15 mg per day), tolperison (Kalmirex), and a neurotropic  multivitamin supplement Compligam B. Patients in the 2nd  group (n=34) received a combination of only two of the three drugs. We assessed pain intensity with VAS, disability duration, and treatment effectiveness from the doctor's and patient's perspectives. 

Results and discussion. After 5 days of treatment, pain regression was noted in both groups; pain reduction by 50% or more from the initial level prevailed in 1st group (p=0.03). A rapid NSAID dose decrease prevailed in the 1st group; from the 5th to the 10th day, all patients switched to the 7.5 mg meloxicam dose. The duration of temporary disability in the 1st group was less than 7 days, in the 2nd group – 9 days (p<0.05). Complex therapy in group 1 was more effective than therapy in group 2, according to doctors and patients (p<0.05). 

Conclusion. The combination of NSAID with a muscle relaxant and B vitamins can reduce the duration and the incidence of  adverse drug reactions of NSAID therapy, and reduce the  duration of temporary disability. 

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