Abstract:

Objective: Acute low back pain (LBP) is the leading cause of disability worldwide, whereas the ideal initial treatment protocol is still under debate. The aim of this study was to question, whether acetaminophen combined with etodolac or diclofenac could provide efficient ease of symptoms in patients with acute LBP and to assess whether one combination could be superior compared to the other in terms of clinical and functional outcomes, with health-related quality of life. Materials and Methods: A retrospective, comparative study of 67 patients with acute, non-radicular, and non-traumatic LBP was undertaken. Patients were assessed in two groups, whereas daily, group one [34 patients, mean age of 47.1 (range 24-56)] received 4x500 mg acetaminophen combined with 2x400 mg etololac and the group two [33 patients, mean age of 44.8 (range 26-53)] received 4x500 mg acetaminophen combined with 2x75 mg diclofenac, for one week. Patients’ pre-treatment and post-treatment visual analog scale (VAS), Oswestry Disability Index (ODI), and Roland-Morris Disability Questionnaire (RMDQ) scores were recorded and compared. Results: Group 1-2 had a pre-treatment mean VAS back score of 7.4-7.1, ODI score of 76.2-75.8 and RMDQ score of 18.2-19.4 improved to 1.4-1.3, 16.1-16.4, and 5.8-6.2 at the end of 1st week (p<0.001 for all), which further improved to 1.1-1.2, 15.8-15.3, and 3.3-3.2 (p<0.001 for all) at the end of 12th week. Intergroup comparison yielded no statistically significant data (p>0.05 for all). Conclusion: Daily 2000 mg acetaminophen combined with 800 mg etodolac or 150 mg diclofenac could provide effective and sustained pain relief, with significant clinical and functional amelioration resulting in significant improvements in health-related quality of life, if applied under strict indication criteria to patients with acute non-traumatic and non-radicular LBP.

Keywords: