Does diazepam help discharged patients with acute non-radicular lower back pain?
Title of Paper:
Diazepam Is No Better Than Placebo When Added to Naproxen for Acute Lower Back Pain
Journal and Year:
Annals of Emergency Medicine, 2017
114 ED adult patients with acute, non-traumatic, non-radicular lower back pain for < 2 weeks
Naproxen 500mg BD plus Diazepam 5-10mg BD PRN
Naproxen 500mg BD plus Placebo BD PRN
Improvement in Roland-Morris Disability Questionnaire between ED discharge and one week follow up
Summary of Results:
No difference (not just statistically but literally no difference – both improved by 11 points) in questionnaire score at one week between the groups
Secondary outcomes (a reasonable list – check out the paper) also looked pretty similar.
Prospective, randomised, double blind, placebo controlled study
Sample size calculation to assess for clinically significant difference
Objective and validated primary outcome measure
Good variety of secondary outcomes if you fancy a read
Excellent follow up to one week and three months – kept >50 in each arm in keeping with their sample size calculation
Excluded patients with radicular pain and didn’t assess patients for the presence or absence of muscle spasm – surely these are the patient’s that would benefit the most from a muscle relaxant.
Clinical Bottom Line:
This study proves that diazepam is not an analgesic.