Abstract

COMPARATIVE EFFICACY AND SAFETY OF METHOCARBAMOL AND THIOCOLCHICOSIDE IN ACUTE LOW BACK PAIN.

*Sudarsini Saravanabhavan, Vitthal Kuchake, Fahad I.Al-Saikhan

ABSTRACT

Purpose To evaluate the efficacy and safety of either oral methocarbamol or thiocolchicoside in combination with paracetamol in acute low back pain associated with muscle spasm. Methods: Study Design: Prospective, randomized, single blind, single centre comparative study. 201 patients were randomized to receive either a methocarbamol 500 mg p.o. thrice daily (group M) or a thiocolchicoside 8 mg p.o. twice daily (group T) with paracetamol 650 mg p.o. twice daily for 7 days. Outcome was evaluated primarily by visual analogue scale (VAS) and secondarily by hand-to-floor distance, visual and palpable muscle spasm and Oswestry disability index (ODI) at baseline visit, day 3, and 7 and based on patients’ global evaluation. Adverse effects were monitored. Results: The pain intensity, as measured by VAS, showed significant reduction of pain in both groups on day 3, and 7 but improvement was better in group M as compared to group T(p<0.0001). Hand-to-floor distance and muscle spasm decreased significantly (p<0.005 for HFD, p<0.006 for visible and p<0.0001 for palpable spasm) on day 7 in group M as compared to group T. Mean % ODI scores improved significantly on both day 3 and 7 (p<0.0001) in group M as compared to group T. Patients’ global evaluation showed 80% of patients in group M evaluated the treatment as very good. Both treatments were well tolerated and group T had more adverse effects, the most common being diarrhea. Conclusion: It is concluded that either methocarbamol or thiocolchicoside in combination with paracetamol are effective in acute LBP with spasm. Methocarbamol is superior in efficacy as well as safety. Running Title: Methocarbamol / Thiocolchicoside in acute LBP.

Keywords: Acute / Low back pain / Muscle spasm / Muscle relaxant / Methocarbamol /Thiocolchicoside.