Tolperisone in the treatment of acute and chronic nonspecific back pain

Abstract

Nonspecific back pain (NBP) is one of the most common reasons to see a neurologist or therapist. Acute (<4 weeks' duration), subacute (4 to 12 weeks), and chronic (>12 weeks) NBPs are recognized. The diagnosis of NBP is based on anamnestic data, somatic, neurological, and neurologic-and-orthopedic examination findings and on the exclusion of the specific causes of back pain, discogenic radiculopathy, and vertebral canal stenosis. Nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants are used in the pharmacotherapy of acute, subacute, and chronic NBP. Tolperisone is widely used as a muscle relaxant in Russia and in the countries of Europe and Asia. Clinical trials have shown the efficacy and good tolerance of tolperisone used alone and in combination with NSAIDs for NBP. The review presents clinical recommendations from different countries on the use of muscle relaxants in the treatment of acute and chronic NBP. It is concluded that a large-scale qualitative randomized trial should be conducted to investigate the efficacy of muscle relaxants, tolperisone in particular, in the treatment of acute, subacute, and chronic NBP.

A Comparative Study on Efficacy and Safety of Tolperisone Versus Tizanidine in Patients Suffering From Acute Low Back Pain With Muscle Spasm

“…The results of five studies (3 RCTs and 2 case series) suggest that Tolperisone intervention (7-14 days) may be effective in patients with acute LBP compared to placebo/thiocolchicoside/diazepam [3][4][5] and in before and after treatment studies [6,7].…”

“…Tolperisone hydrochloride, a piperidine derivative, is centrally acting muscle relaxant used for treatment muscle spasm associated and pain. We also sought to draw a conclusion whether Tolperisone finds its place in the treatment of acute LBP and thus aiding the clinicians in choosing the appropriate drug for acute LBP associated with muscle spasm [3][4][5].…”