[Effects of back pain treatment with tizanidine]

[corrected] Back pain is a common reasons for seeking medical advice. Its high prevalence and increasing incidence in younger patients is making back pain a major disease of civilization. Back pain is usually accompanied by increased muscle spasm, so centrally-acting muscle relaxants are used in its treatment together with NSAIDs.

The aim of our study was to evaluate the treatment of back pain with tizanidine (Sirdalud) and NSAID's. 162 patients (121 women and 41 men, mean age 55.6 years) were treated for back pain in our outpatient clinic in Bydgoszcz, Poland, from January to May 2004. Symptoms were assessed by VAS (visual analogue scale) during the initial and follow-up visits (at 4-5 and 10-14 days). X-ray was performed after the first visit. The control group consisted of 154 patients (101 women and 53 men, mean age 52.3 years) were treated with NSAIDs only. The parameters assessed included time to initial pain relief (VAS decrease of at least 1 point with total score remaining above 1 on the 10-point scale) and time to complete pain relief (VAS less than 1 point), total dose of tizanidine needed for initial and complete pain relief, and adverse effects.

Tizanidine used in back pain accompanied by muscle spasm results in quick pain relief (initial relief on the 2nd day of treatment, complete relief after 4 days, vs. initial relief on the 3rd day of treatment, complete after 7 days in the control group). The daily dosage and cumulative dose needed to achieve analgesic effect is low (lowest recommended dose by the producer). Tizanidine is well tolerated: adverse effects were rare (<6%, vs. 13% in the control group) and transient. The clinical effect of tizanidine was prompt in acute pain and more delayed in chronic disease.