Naproxen Alone May Be Best for Acute Low Back Pain


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Am Fam Physician. 2016 Feb 15;93(4):316.

Clinical Question

What is the optimal medication regimen for treating adults with acute low back pain (LBP)?

Bottom Line

Naproxen alone is as effective as naproxen plus oxycodone/acetaminophen or naproxen plus cyclobenzaprine (Flexeril) in reducing pain and improving function in adults with acute musculoskeletal LBP without radicular symptoms. Adverse events were significantly more common in patients additionally treated with either muscle relaxants or opioids. Be sure to note the exclusion criteria in the synopsis. (Level of Evidence = 1b)


Clinicians commonly treat acute LBP with a combination of nonsteroidal anti-inflammatory drugs, muscle relaxants, and opioids. These investigators identified adults (N = 323), 21 to 64 years of age, presenting to the emergency department

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP,search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.


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Oct 15, 2016

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