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ced5a5f5e9 Benzodiazepenes were not considered primary drugs in this report. Common musculoskeletal conditions causing tenderness and muscle spasms include fibromyalgia,8 tension headaches,9 myofascial pain syndrome, and mechanical low back or neck pain. This scale was originally devised to test the strength of polio survivors. The validity of controlled trials depends on how they are designed. Howarth, MD Katie Hughes, MD Jonathan Jones, MD Laurence Katz, MD Ruby Long, MD James E Manning, MD Ian B.
We recorded rates of these adverse events as well as rates of discontinuation of treatment due to a particular adverse effect. Musculoskeletal conditions were defined as peripheral conditions resulting in muscle or soft tissue pain or spasms. The participating organizations approved the following key questions to guide this review: What is the comparative efficacy of different muscle relaxants in reducing symptoms and improving functional outcomes in patients with a chronic neurologic condition associated with spasticity, or a chronic or acute musculoskeletal condition with or without muscle spasms?What are the comparative incidence and nature of adverse effects (including addiction and abuse) of different muscle relaxants in patients with a chronic neurologic condition associated with spasticity, or a chronic or acute musculoskeletal condition with or without muscle spasms?Are there subpopulations of patients for which one muscle relaxant is more effective or associated with fewer adverse effects?Several aspects of the key questions deserve comment:PopulationThe population included in this review is adult or pediatric patients with spasticity or a musculoskeletal condition. Categorical pain scales, on the other hand, consist of several pain category options from which a patient must choose (e.g., no pain, mild, moderate, or severe). Skeletal muscle relaxants are a heterogeneous group of medications commonly used to treat two different types of underlying conditions: spasticity from upper motor neuron syndromes and muscular pain or spasms from peripheral musculoskeletal conditions. These drugs are often used for treatment of musculoskeletal conditions whether muscle spasm is present or not.12 Although there is some overlap between clinical usage (tizanidine in particular has been studied for use in patients with musculoskeletal complaints),24 in clinical practice each skeletal muscle relaxant is used primarily for either spasticity or for musculoskeletal conditions. 403 Forbidden . It acts by central blockade of GABAA receptors.18, 19 Other medications used to treat spasticity but not formally approved for this indication include other benzodiazepines, clonidine, gabapentin, and botulinum toxin.17. Other medications used for spasticity but considered to be in another drug class, such as gabapentin (a neuroleptic) and clonidine (an antihypertensive), were also only reviewed when they were directly compared to an included skeletal muscle relaxant.