Baclofen is the drug of choice in Spasticity and muscle spasm but it is also indicated for Low Back Pain.This is the evidence in favor of Baclofen for the use in Low Back Pain

1. Prepared by
Muhammad Nizam Uddin

2. Low back pain refers to pain felt in your lower back.
May be characterized by-
 back stiffness,
 decreased movement of the lower back, and
 difficulty standing straight.

3. 1. Local pain in lumber area
2. Local tenderness on palpation of lumber area
3. Paravertebral muscle spasm
4. Interference with daily activity
5. Limitation of motion
6. Active straight –leg-raising test
7. Forward flexion
8. Physician’s opinion of low back syndrome
9. Patient’s opinion of low back syndrome
Ref: Baclofen for the treatment of acute low-back syndrome. A double-blind
comparison with placebo; Spine (Phila Pa 1976). 1985 May;10(4):345-9.

4. GABAB derivative
Centrally acting skeletal mucle relaxant-
Having Antinociceptive effect
Having inhibitory effect on excitatory
neurotransmitters (Aspartate and Glutamate)
Having inhibitory effects on Substance P
(Pain transmitting chemical)

5. Baclofen , inhibits the release of Substance P 1
Baclofen, blocks Nociceptor.
Baclofen , reduces the frequency and severity of
painful and disabling flexor or extensor spasms
accompanying various neurological disorders. 2
Baclofen , reduces protracted tonic flexor dystonias of
the lower extremities in patient with spinal spasticity.3
Ref:
1.www.wayneanderson.net
2.An evaluation of baclofen treatment for certain symptoms in patients with spinal cord
lesions;Neurology 26: 441-446,1976
3.Acta Neurol scand 51: 158-166, 1975

6. Study shows that1
,
After 4 days Baclofen was effective for two parameters
(Interference with daily activity andlimitation of
motion)
After 14 days Baclofen was effective in all the nine
parameters (parameters are in Slide no-2)
Baclofen is safe for low term use (up to Six years)
Baclofen has a greater bioavailability (70-80 %)
Ref: Baclofen for the treatment of acute low-back syndrome. A double-blind
comparison with placebo; Spine (Phila Pa 1976). 1985 May;10(4):345-9.

7. Baclofen has low stress on liver ( 15 %)
Baclofen is not contraindicated with oral
contraceptive like other muscle relaxant.
Baclofen is not contraindicated with Ciprofloxacin
and Fluoroquinolone like other muscle relaxant.

8. Spasticity
Muscle spasm
Muscular rigidity
Hiccup
Trigeminal neuralgia (Jaw and facial pain)
Dysfunctional voiding ( Consequence of the
contraction of female external urethral sphincter)
Cluster Headache ( One sided severe, sudden
headache with tearing of the eyes and stuffy nose)

9. For low back pain:
30-80mg daily in three divided doses

10. Thank You