Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for patients with acute back pain. In emergency settings, benzodiazepines, such as diazepam, are often concomitantly prescribed, but there is no clear evidence to support this practice.
Reporting in Annals of Emergency Medicine
(online, 7 February 2017), researchers studied 112 patients who attended an emergency department for acute lower back pain and were randomly assigned to receive the NSAID naproxen plus placebo, or naproxen plus diazepam for one week.
One week following discharge, scores on the Roland-Morris Disability Questionnaire had improved by the same amount — 11 points — in both groups of patients. The researchers also found that the percentage of patients reporting moderate or severe pain was 22% in those assigned to placebo compared with 32% in the diazepam group.
The team concludes that diazepam should not routinely be added to NSAIDs for the treatment of acute lower back pain.
 Friedman BW, Irizarry E, Solorzano C et al. Diazepam is no better than placebo when added to naproxen for acute low back pain. Ann Emerg Med 2017; doi: 10.1016/j.annemergmed.2016.10.002