baclofen low-back-pain-by-muhammad-nizam-uddin
TRANSCRIPT
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.
1. Local pain in lumber area2. Local tenderness on palpation of lumber
area3. Paravertebral muscle spasm4. Interference with daily activity5. Limitation of motion6. Active straight –leg-raising test7. Forward flexion8. Physician’s opinion of low back syndrome9. 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.
GABA B derivativeCentrally acting skeletal mucle relaxant-
Having Antinociceptive effectHaving inhibitory effect on excitatory
neurotransmitters (Aspartate and Glutamate)
Having inhibitory effects on Substance P (Pain transmitting chemical)
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.net2.An evaluation of baclofen treatment for certain symptoms in patients with spinal cord lesions;Neurology 26: 441-446,19763.Acta Neurol scand 51: 158-166, 1975
Study shows that 1, 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.
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.
SpasticityMuscle spasmMuscular rigidityHiccupTrigeminal 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)