Paper Chase 4 - Adding Diazepam in Acute Low Back Pain

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Nurses Edition Commentary

Lisa Chavez, RN and Kathy Garvin, RN
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Sean G., M.D. -

My critiques of this article is they 1. did not differentiate the multi variant causes of LBP
lumping all LBP as if one entity. The most common cause of LBP in this age group studied will be osteoarthritis DDD and DJD. It stands to reason NSAIDs would be the treatment of choice, its common sense. What would have been nice would be to have seen a placebo group that got neither and see if there was any difference between them and NSAIds esp considering the research presented on this same program regarding heart disease and nsaid usage. I also would have liked to seen the authors identify a group with actual muscle spasm as part of their presentation. I believe if this group was sub analyzed you would see symptom improvement with muscle relaxants in this group. I am surprised no one commented on this. Also cross the board recommendation for NSAIDS and Ice IMOP is a bad idea, most likely ice and NSAIDS will be counter productive with a primary etiology of spasm. Heat would be better.

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