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Treatment of acute non-specific back pain, the use of group B vitamins

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Acute musculoskeletal (non-specific) back pain is one of the most common causes of medical visits and temporary disability. A patient with acute non-specific back pain should be informed about the benign nature of the disease, a favorable prognosis, the expediency of maintaining physical activity, and receive a recommendation to avoid bed rest. Non-steroidal anti-inflammatory drugs and muscle relaxants are most commonly used to relieve the pain. The use of group B vitamins as additional analgesics in acute non-specific back pain is discussed, data from placebo-controlled studies and a meta-analysis of studies on the use of group B vitamins as additional analgesics are analyzed. Data on the positive role of neurotropic group B vitamins in the prevention of relapses in patients with back pain are presented. The possibilities of therapeutic exercises in the prevention of repeated episodes of back pain are discussed.

About the Author

V. A. Parfenov
Department of Nervous Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Vladimir Anatolyevich Parfenov

119021, Moscow, Rossolimo St., 11, Build. 1

Competing Interests:

The conflict of interest has not affected the results of the investigation.


1. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet Neurol. 2017;389(10070):736-47. doi:10.1016/S0140-6736(16)309709

2. Parfenov VA, Isaykin AI. Boli v poiyasnichnoyoblasti [Pain in the lumbar region]. Moscow; 2018. Available from: (In Russ.).

3. Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Aug 22;386(9995):743-800. doi:10.1016/S0140-6736(15)60692-4. Epub 2015 Jun 7.

4. Low Back Pain and Sciatica in Over 16s: Assessment and Management. Clinical Guidelines. London: National Institute for Health and Care Excellence (UK); 2016. Available from:

5. Parfenov VA, Yakhno NN, Kukushkin ML, et al. Acute nonspecific (musculoskeletal) low back pain. Guidelines of the Russian Society for the Study of Pain (RSSP). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(2):4-11. doi:10.14412/2074-2711-2018-2-4-11 (In Russ.).

6. Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-30. Available from:

7. Jenkins HJ, Hancock MJ, Maher CG, et al. Understanding patient beliefs regarding the use of imaging in the management of low back pain. Eur J Pain. 2016 Apr;20(4):573-80. doi:10.1002/ejp.764. Epub 2015 Aug 18.

8. Chiu CC, Chuang TY, Chang KH, et al. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil. 2015 Feb;29(2):184-95. doi:10.1177/0269215514540919. Epub 2014 Jul 9.

9. Waddel G. The back pain revolution. Churchill Livingstone; 1998. Available from:

10. Kuritzky L, Samraj GP. Nonsteroidal anti-inflammatory drugs in the treatment of low back pain. J Pain Res. 2012;5:579-90. doi:10.2147/JPR.S6775

11. Enthoven WT, Roelofs PD, Deyo RA, et al. Non-steroidal anti-inflammatory drugs for chronic low back pain. Cochrane Database Syst Rev. 2016 Feb 10;2(2):CD012087. doi:10.1002/14651858.CD012087

12. Van Tulder MW, Touray T, Furlan AD, et al. Muscle relaxants for non-specific low back pain. Cochrane Database Syst Rev. 2003;(2):CD004252. doi:10.1002/14651858.CD004252

13. Pareek A, Chandurkar N, Chandanwale AS, et al. Aceclofenac-tizanidine in the treatment of acute low back pain: a double-blind, doubledummy, randomized, multicentric, comparative study against aceclofenac alone. Eur Spine J. 2009 Dec;18(12):1836-42. doi:10.1007/s00586-009-1019-4

14. Kukushkin ML, Brylev LV, Laskov VB, et al. The results of a randomized double-blind parallel study of the efficacy and safety of tolperisone in patients with acute non-specific low back pain. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2017;117(11):69-78. doi:10.17116/jnevro201711711169-78 (In Russ.).

15. Gerasimova ON, Parfenov VA, Kalimeeva EYu. Treatment of patients with acute and subacute dorsalgia. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(3):36-41. doi:10.14412/2074-2711-2018-3-36-41 (In Russ.).

16. Parfenov VA, Kalimeeva EYu, Gerasimova ON. Management of patients with acute back pain now and 10 years ago. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(1):66-71. doi:10.14412/2074-2711-2019-1-66-71 (In Russ.).

17. Kousar S, Sheikh MA, Asghar M. Antiglycation activity of thiamin-HCl and benfotiamine in diabetic condition. J Pak Med Assoc. 2012 Oct;62(10):1033-8.

18. Mashkovsky MD. Lekarstvennyye sredstva: posobiye dlya vrachey [Medicines: a guide for doctors]. 14<sup>th</sup> ed., revised, corrected and additional. Moscow: Novaya Volna, Publisher S.B. Divov; 2002. Vol. 2. P. 72-84 (In Russ.).

19. Mibielli MA, Geller M, Cohen JC, et al. Diclofenac plus B vitamins versus diclofenac monotherapy in lumbago: the DOLOR study. Curr Med Res Opin. 2009 Nov;25(11):2589-99. doi:10.3111/13696990903246911

20. Calderon-Ospina CA, Nava-Mesa MO, Arbelaez Ariza CE. Effect of Combined Diclofenac and B Vitamins (Thiamine, Pyridoxine, and Cyanocobalamin) for Low Back Pain Management: Systematic Review and Meta-analysis. PainMed. 2020 Apr 1;21(4):766-81. doi:10.1093/pm/pnz216

21. Danilov AB. The use of B vitamins for back pain: new analgesics? RMJ. 2008;16(30)35-9. Available from: (In Russ).

22. Schwieger G. Zur Frage der Rezidiv prophylaxes von schmerzhaften Wirbelsäulen syndromen durch B-Vitamine. Ergebnisse einer randomisierten Doppelblind studie Neurobion forte (Vitamin B1, B6, B12) gegen Placebo. In: Zöllner N, Fassl H, Jurna I, Pietrzik KF, Schattenkirchner M, editors. Klinische Bedeutung von Vitamin B1, B6, B12 in der Schmerztherapie. Darmstadt: Dietrich Steinkopff; 1988. S. 169-81.

23. Observational Study Of Effectiveness And Safety Of Add-On Milgamma® And Milgamma® Compositum Step-Therapy In: Routine Practice of Management of Adult Patients With Acute Non-Specific Low Back Pain Receiving Modern NSAIDs, WP-RU2018/1, Woerwag Pharma LLC.

24. Van den Hoogen HJ, Koes BW, van Eijk JT, et al. On the course of low back pain in general practice: a one year follow up study. Ann Rheum Dis. 1998 Jan;57(1):13-9. doi:10.1136/ard.57.1.13

25. Da Silva T, Mills K, Brown BT, et al. Recurrence of low back pain is common: a prospective inception cohort study. J Physiother. 2019 Jul;65(3):159-65. doi:10.1016/j.jphys.2019.04.010. Epub 2019 Jun 14.

26. Takahashi N, Omata JI, Iwabuchi M, et al. Therapeutic efficacy of nonsteroidal anti-inflammatory drug therapy versus exercise therapy in patients with chronic nonspecific low back pain: a prospective study. Fukushima J Med Sci. 2017;63(1):8-15. doi:10.5387/fms.2016-12

27. Magalhaes MO, Comachio J, Ferreira PH, et al. Effectiveness of graded activity versus physiotherapy in patients with chronic nonspecific low back pain: midterm follow up results of a randomized controlled trial. Braz J Phys Ther. 2018;22(1):82-91. doi:10.1016/j.bjpt.2017.07.002

28. Hayden JA, Wilson MN, Stewart S, et al. Exercise treatment effect modifiers in persistent low back pain: an individual participant data meta-analysis of 3514 participants from 27 randomised controlled trials. Br J Sports Med. 2020;54(21):1277-8. doi:10.1136/bjsports2019-101205

29. Saner J, Bergman EM, de Bie RA, Sieben JM. Low back pain patients' perspectives on long-term adherence to home-based exercise programmes in physiotherapy. Musculoskelet Sci Pract. 2018;38:77-82. doi:10.1016/j.msksp.2018.09.002

30. Saragiotto BT, Maher CG, Yamato TP, et al. Motor Control Exercise for Nonspecific Low Back Pain: A Cochrane Review. Spine (Phila Pa 1976). 2016;41(16):1284-95. doi:10.1097/BRS.0000000000001645

31. Owen PJ, Miller CT, Mundell NL, et al. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. Br J Sports Med. 2020;54(21):1279-87. doi:10.1136/bjsports2019-100886

32. Paolucci T, Attanasi C, Cecchini W, et al. Chronic low back pain and postural rehabilitation exercise: a literature review. J Pain Res. 2018;12:95-107. doi:10.2147/JPR.S171729

33. Yamato TP, Maher CG, Saragiotto BT, et al. Pilates for Low Back Pain: Complete Republication of a Cochrane Review. Spine (Phila Pa 1976). 2016;41(12):1013-21. doi:10.1097/BRS.0000000000001398

34. O'Connor SR, Tully MA, Ryan B, et al. Walking exercise for chronic musculoskeletal pain: systematic review and meta-analysis. Arch Phys Med Rehabil. 2015 Apr;96(4):724-734.e3. doi:10.1016/j.apmr.2014.12.003. Epub 2014 Dec 19. Erratum in: Arch Phys Med Rehabil. 2015 Jun;96(6):1182.

35. Vanti C, Andreatta S, Borghi S, et al. The effectiveness of walking versus exercise on pain and function in chronic low back pain: a systematic review and meta-analysis of randomized trials. Disabil Rehabil. 2019;41(6):622-32. doi:10.1080/09638288.2017.1410730

36. Sitthipornvorakul E, Klinsophon T, Sihawong R, Janwantanakul P. The effects of walking intervention in patients with chronic low back pain: A meta-analysis of randomized controlled trials. Musculoskelet Sci Pract. 2018;34:38-46. doi:10.1016/j.msksp.2017.12.003

37. Steffens D, Maher CG, Pereira LS, et al. Prevention of Low Back Pain: A Systematic Review and Meta-analysis. JAMA Intern Med. 2016 Feb;176(2):199-208. doi:10.1001/jamainternmed.2015.7431


For citations:

Parfenov V.A. Treatment of acute non-specific back pain, the use of group B vitamins. Neurology, Neuropsychiatry, Psychosomatics. 2022;14(6):98-102. (In Russ.)

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