To compare the efficacy and safety of fixed dose combination of thiocolchicoside and aceclofenac versus chlorzoxazone, aceclofenac and paracetamol in patients with acute lower backache associated with muscle spasm

Abstract

Background:The fixed dose combinations (FDCs) of muscle relaxants, non-steroidal anti-inflammatory drugs and paracetamol are commonly prescribed in the treatment of acute lower backache.Aim:The present study was undertaken with the aim of comparing the efficacy and safety of FDCs of thiocolchicoside and aceclofenac versus chlorzoxazone, aceclofenac and paracetamol in patients with acute lower backache associated with muscle spasm.Materials and Methods:A total of 100 patients between ages range from 18 and 55 years having low back pain of ≤7 days duration were randomly divided into two groups. Group A was prescribed thiocolchicoside (4 mg) + aceclofenac (100 mg) while Group B was prescribed chlorzoxazone (500 mg) + aceclofenac (100 mg) + paracetamol (325 mg) orally twice daily for 7 days. Severity of pain at rest and on movement was recorded using visual analogue scale. Muscle spasm was evaluated by hand-to-floor distance and Lasegue's maneuver. Readings were noted on day 1 (baseline), day 3 and day 7.Results:There was statistically significant reduction in severity of pain and muscle spasm on day 3 and day 7 in both groups. There was no statistically significant difference in pain relief and muscle spasm among the treatment groups but clinically showed better improvement in the Group A. The adverse drug reactions occurring during study showed a statistically significant better safety profile in the Group A than Group B.Conclusion:These findings confirm that FDC of thiocolchicoside and aceclofenac is a preferred option for patients with lower backache pain associated with muscle spasm.

Investigating the Effect of Perioperative Chlorzoxazone on Acute Postoperative Pain After Total Hip and Knee Replacement Surgery

“…Nielsen et al 20 demonstrated no reduction in acute postoperative pain after a single 500 mg administration of chlorzoxazone after spine surgery for patients with moderate-to-severe pain, which is in line with present study. Furthermore a study by Kumar et al 29 investigated the efficacy of the combination of thiocolchicoside and aceclofenac versus…”

Etiology, Evaluation, and Treatment of Failed Back Surgery Syndrome

“…Muscle relaxants such as thiocolchicoside, a competitive gamma-aminobutyric acid (GABA) receptor antagonist, are a good treatment option for patients with muscle spasm-associated low back pain [ 38 ]. Similarly, tolperisone, a piperidine derivative and centrally acting muscle relaxant, is an effective option in the presence of skeletal muscle spasm [ 39 ].…”

Fixed combination of non-steroidal anti-inflammatory drug and muscle relaxant as the basis for rational therapy of pain syndromes: A review

“…Зачастую для получения максимального эффекта требуются высокие дозы НПВП и миорелаксантов, что увеличивает риск возникновения побочных эффектов со стороны желудочно-кишечного тракта, способствует резкому снижению/повышению артериального давления (АД), появлению выраженного седативного эффекта, спутанности сознания, головокружения, слабости и нарушения координации, ухудшению когнитивных функций [20]. В то же время правильная с позиции фармакологии комбинация имеет преимущества по сравнению с монопрепаратами, особенно у пожилых пациентов, у которых может быть недостаточный или «извращенный» ответ на отдельное ЛС, особенно при наличии артериальной гипертензии [19].…”