Study: Is Diazepam Effective for the Treatment of Acute Low Back Pain?

According to a new study, naproxen plus diazepam did not improve functional outcomes or pain compared with naproxen plus placebo at either 1 week or 3 months after discharge from the emergency department (ED). The study included 114 participants who scored a 5 or above on the Roland-Morris Disability Questionnaire before being discharged from an ED. Researchers randomly assigned 55 patients to receive 20 tablets of naproxen 500 mg to take twice a day and 28 tablets of diazepam 5 mg to take every 12 hours as needed, and 57 patients to receive naproxen and 28 tablets of a placebo to take every 12 hours as needed. All patients participated in a 10-minute standardized educational session before they were discharged. Pain intensity and improvement in Roland-Morris Disability Questionnaire score were assessed at 1 week department, and 3 months after discharge from an ED using a 4-point descriptive scale. Researchers found that the mean Roland-Morris Disability Questionnaire of patients on naproxen and diazepam improved by 11. Likewise, the mean score of patients on naproxen and placebo improved by 11. At the 1-week follow-up, 18 patients on diazepam reported moderate or severe low back pain compared to 12 in the placebo group. Six patients on diazepam reported moderate or severe low back pain at 3 months compared to 5 in the placebo group. Adverse events were reported by 8 of the placebo and 12 of the diazepam patients. “Among ED patients with acute, nontraumatic, nonradicular low back pain, naproxen+diazepam did not improve functional outcomes or pain compared with naproxen+placebo 1 week and 3 months after ED discharge,” the researchers concluded. —Melissa Weiss Reference: Friedman BW, Irizarry E, Solorzano C, et al. Diazepam is no better than placebo when added to naproxen for acute low back pain [published online February 7, 2016]. Ann Emerg Med. https://dx.doi.org/10.1016/j.annemergmed.2016.10.002.