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)
 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