Medication Summary
The goal of pharmacotherapy is to reduce patient morbidity and prevent complications. In acute injuries, pharmacotherapy should usually not exceed 6 weeks of treatment.
Muscle relaxants
Class Summary
In the acute phase, muscle relaxants (IM injection or tablets) help to treat muscle spasms and facilitate light physical therapy. [16] However, muscle relaxants have not been shown to shorten or alter the course of the injury process.
Methocarbamol (Robaxin)
Exact mechanism in humans not known. May be due to general central nervous system (CNS) depression. Has no direct action on contractile mechanism of striated muscles, the motor endplate, or the nerve fiber. Indicated as an adjunct to rest, physical therapy, and other measures for the relief of the discomfort associated with acute pain and painful musculoskeletal conditions.
Nonsteroidal anti-inflammatory drugs (NSAIDS)
Class Summary
NSAIDs are generally used to treat muscle pain in the acute and maintenance phases of treatment. These drugs usually have anti-inflammatory, analgesic, and antipyretic activities. The ability of NSAIDs to inhibit prostaglandin synthesis may be involved in the anti-inflammatory effect; these agents are indicated in the acute and maintenance phase of the pain treatment for lumbosacral injuries.
Selective cyclooxygenase-2 (COX-2) inhibitors are generally not recommended as first-line treatment.
Diclofenac (Voltaren)
Has anti-inflammatory, analgesic, and antipyretic activities. Used to treat acute and continuous pain. In general, patients should be maintained on the lowest dosage of diclofenac that is consistent with achieving a satisfactory therapeutic response.
Ibuprofen (Ibuprin, Advil, Motrin)
Drug has anti-inflammatory, antipyretic, and analgesic activities. Mode of action not known. However, ability to inhibit prostaglandin synthesis may be involved in anti-inflammatory effect. Smallest dose that yields acceptable control of pain should be employed. A therapy longer than 3-6 months may result in gastrointestinal bleeding or ulcers; long-term therapy must be closely observed.
