Does Baclofen Really Have a Role in the Management of Acute Lower Backpain: A Prospective Study

Acute lower back pain (LBP) is a common musculoskeletal condition with significant clinical and socioeconomic impact. Nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants are frequently prescribed; however, the additional benefit of combination therapy remains uncertain. This prospective, double-blinded, randomized comparative study evaluated the efficacy of etoricoxib alone versus etoricoxib combined with baclofen in patients aged 18-65 years with acute mechanical LBP of less than 6 weeks' duration. A total of 310 patients were allocated into two groups: Group A (n = 150) received etoricoxib 60 mg twice daily with topical diclofenac gel, while Group B (n = 160) received etoricoxib 60 mg plus baclofen 20 mg twice daily, along with topical diclofenac gel. All patients underwent standardized physiotherapy, including core strengthening and interferential therapy. Pain and functional outcomes were assessed using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Roland-Morris Disability Questionnaire (RMDQ) at baseline and day 6. Both groups showed significant improvement (p < 0.001), with no significant intergroup differences at day 6 (VAS: p = 0.21; ODI: p = 0.18; RMDQ: p = 0.23). Etoricoxib alone provides comparable short-term outcomes, and routine addition of baclofen may not offer additional benefit.