For decades, Valium was often given by emergency room staff for an acute bout of poor lower back pain.
But a new head to head trial within an ER environment throws doubt on the idea that Valium or strong painkillers can definitely help.
"Our study contributes to the growing body of literature suggesting that, generally speaking, most medications don't enhance acute lower back pain," lead researcher Dr. Benjamin Friedman, of the Albert Einstein College of Medicine in New York City, said in a journal news release.
"By three months after visiting the emergency department, most patients had recovered completely, regardless of what treatment they received."
The brand new findings are in tune with guidelines issued Feb. 13 by the American College of Physicians. That group also strongly advocates that individuals with low back pain strive drug free remedies — from simple heat wrappings before resorting to drugs. And if drugs are used, patients should stick to milder painkillers such as naproxen or ibuprofen, or muscle relaxants.
In treating lower back pain, one specialist agreed back pain can be extremely tough to treat.
"Low back pain is one of the utmost effective reasons that people visit emergency departments, accounting for about 2.7 million ED visits per year nationally," said Dr. Eric Cruzen. He directs emergency medicine at Lenox Health Greenwich Village, in Nyc.
"Despite how common this grievance is, there hasn't been much agreement on the most effective treatment," Cruzen said. The newest findings "indicate that providers should consider other alternatives for the treatment of non-stabbing low back pain," he added.
After one week, moderate or severe back pain was still reported by 31.5 percent of patients in the Valium group and about 22 percent of those in the placebo group.
The rates were 12 percent and 9 percent, respectively, the researchers found.
"Millions of patients arrive at the ER every year seeking relief for back pain, which could be debilitating," Friedman said. "Unfortunately, we have yet to think of the silver bullet in pill form that helps them. If anything, we may be overmedicating these patients."
Overmedication — especially when potentially addictive drugs for example opioids or benzodiazepines are used — comes using its own risks, Cruzen said. Valium is a benzodiazepine.
"Since benzodiazepines are controlled substances secondary to their own addiction and abuse possible, they should just be given if they really help the individual 's condition," Cruzen said.
Dr. Robert Duarte directs Northwell Health's Pain Center in Great Neck, N.Y. He reviewed the study and said it did have some limits — for example, individuals with a preexisting history of back pain or sciatica were not contained in the trial, and the study did not test the effectiveness of Valium on its own (without naproxen).
Still, Duarte concurred that the study appears to give more weight to the opinion that Valium is of little use in these cases.
"This study helps to further support the truth that diazepam or some benzodiazepines shouldn't be regarded as an initial option for patients for severe back pain," he said at health message boards.