Use of thiocolchicoside for acute non-specific (musculoskeletal) low back pain

The treatment of acute non-specific (musculoskeletal) lower back pain (LBP) is a pressing issue in modern medicine, as LBP is one of the most common causes of temporary disability among the population. In cases of acute non-specific LBP, the patient should be informed in simple terms about the good prognosis and the absence of the need for instrumental examination methods if there are no dangerous symptoms (red flags). It is important to inform the patient about the benign nature of the disease, the high probability of a quick recovery, and the advisability of maintaining an active lifestyle. To reduce pain, the use of short-course non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants is effective. Data on the use of the muscle relaxant thiocolchicoside (Tiplito) in acute LBP are discussed. Thiocolchicoside has been used for a long time to treat LBP, neck pain, and other musculoskeletal pain. The results of placebo-controlled randomised clinical trials (RCTs) demonstrating the efficacy and good tolerability of a short course of thiocolchicoside in acute LBP are analysed. Data from a recent systematic review and meta-analysis of eight RCTs (more than 1,000 patients) on the use of thiocolchicoside for musculoskeletal pain are presented. Thiocolchicoside (Tiplito) is recommended as an adjuvant therapy for painful muscle spasms in acute spine pathology in the form of intramuscular injections (4–8 mg per day) for 5 days. The combination of thiocolchicoside with NSAIDs enhances the analgesic effect of the latter, improves the functional status of patients, and reduces the duration of NSAID use. Issues related to the optimisation of management of patients with acute non-specific LBP are discussed.

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