Combining naproxen with other analgesics does not improve low back pain

A ten-day course of naproxen and placebo was just as effective at relieving low back pain as naproxen combined with other pain medications.

Researchers have found that adding other analgesics to naproxen does not improve low back pain. In the image, a man with low back pain
Low back pain is often treated with a combination of analgesics, but there may not be evidence for this practice

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Low back pain is responsible for 2.7 million US emergency department visits each year, with analgesic drugs commonly used in combination to treat patients.

Researchers from the Albert Einstein College of Medicine in New York conducted a randomised clinical trial involving 323 patients to test whether a ten-day course of muscle relaxants or opioids combined with a non-steroidal anti-inflammatory drug (NSAID) was more effective than an NSAID used alone to treat non-traumatic low back pain. They found that neither naproxen combined with cyclobenzaprine nor naproxen combined with oxycodone and paracetamol provided better pain relief at seven-day or three-month follow-up than naproxen given with placebo.

“These findings do not support the use of these additional medications in this setting,” the researchers conclude in JAMA (online, 20 October 2015)[1]
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References

[1] Friedman B W, Dym A A, Davitt M et al. Naproxen with cyclobenzaprine, oxycodone/acetaminophen, or placebo for treating acute low back pain: a randomized clinical trial. JAMA 2015;314(15):1572–1580. doi:10.1001/jama.2015.13043

Last updated
Citation
Clinical Pharmacist, CP, November 2015, Vol 7, No 10;7(10):DOI:10.1211/PJ.2015.20069620

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