Muscle relaxers in acute musculoskeletal back pain

Treatment of patients with back pain is a global public health problem. The diagnosis of acute non-specific (musculoskeletal) back pain (ANBP) is made based on anamnestic data, results of somatic, neurological and neuroorthopaedic examinations, and exclusion of specific causes of back pain and discogenic radiculopathy. For ANBP, pharmacological treatment includes non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxers (MR). Most modern clinical guidelines recommend non-benzodiazepine MR as the treatment of choice for ANBP. The results of randomized clinical trials have shown the efficacy and good tolerability of tolperisone (Mydocalm) as monotherapy and in combination with NSAIDs for ANBP. Tolperisone (Mydocalm) has analgesic properties and its main advantage over other MR is that it has no sedative effect.