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McCarberg BH – Recommended topical and systemic pharmacologic treatments for acute low back pain include application of superficial heat, acetaminophen, nonsteroidal anti–inflammatory drugs, skeletal muscle relaxants/benzodiazepines, and opioids including tramadol. Only a small number of studies compared different approaches to treatment of acute back pain and most failed to demonstrate significant differences among treatments. Available results support the view that both NSAIDs and low–level continuous heat treatment are more effective than acetaminophen and that heat treatment is also significantly more effective than ibuprofen.


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