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Use of adjuvants in the treatment of back pain
Last reviewed: 08.07.2025

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Baclofen (Baclofen)
Pills
Pharmacological action
A centrally acting muscle relaxant, a derivative of gamma-aminobutyric acid (GABAb-stimulator). By reducing the excitability of the terminal sections of afferent sensory fibers and suppressing intermediate neurons, it inhibits mono- and polysynaptic transmission of nerve impulses; reduces the preliminary tension of muscle spindles. It has no effect on neuromuscular transmission. In neurological diseases accompanied by spasticity of skeletal muscles, it relieves painful spasms and clonic seizures; increases the range of motion in joints, facilitates passive and active kinesitherapy (physical exercises, massage, manual therapy).
Indications for use
Spasticity in multiple sclerosis, strokes, traumatic brain injury, meningitis, spinal diseases (infectious, degenerative, tumor and traumatic genesis), cerebral palsy; alcoholism (affective disorders).
Diazepam (Diazepam)
Pills
Pharmacological action
Anxiolytic (tranquilizer) of the benzodiazepine series. Has a sedative-hypnotic, anticonvulsant and central muscle relaxant effect.
The mechanism of action of diazepam is due to stimulation of benzodiazepine receptors of the supramolecular GABA-benzodiazepine-chloroionophore receptor complex, leading to increased inhibitory effect of GABA (mediator of pre- and postsynaptic inhibition in all parts of the central nervous system) on the transmission of nerve impulses. Stimulates benzodiazepine receptors located in the allosteric center of postsynaptic GABA receptors of the ascending activating reticular formation of the brainstem and interneurons of the lateral horns of the spinal cord; reduces excitability of subcortical structures of the brain (limbic system, thalamus, hypothalamus), inhibits polysynaptic spinal reflexes.
The anxiolytic effect is due to the influence on the amygdala complex of the limbic system and is manifested in a decrease in emotional tension, a weakening of anxiety, fear, and worry.
The sedative effect is due to the influence on the reticular formation of the brainstem and non-specific nuclei of the thalamus and is manifested by a decrease in symptoms of neurotic origin (anxiety, fear).
The main mechanism of hypnotic action is the suppression of cells of the reticular formation of the brain stem.
The anticonvulsant effect is realized by enhancing presynaptic inhibition. The spread of epileptogenic activity is suppressed, but the excited state of the focus is not removed.
The central muscle relaxant effect is due to inhibition of polysynaptic spinal afferent inhibitory pathways (and to a lesser extent monosynaptic ones). Direct inhibition of motor nerves and muscle function is also possible.
Possessing moderate sympatholytic activity, it can cause a decrease in blood pressure and dilation of coronary vessels. Increases the threshold of pain sensitivity. Suppresses sympathoadrenal and parasympathetic (including vestibular) paroxysms. Reduces nocturnal secretion of gastric juice.
The effect of the drug is observed within 2-7 days of treatment.
It has virtually no effect on productive symptoms of psychotic genesis (acute delusional, hallucinatory, affective disorders); a decrease in affective tension and delusional disorders is rarely observed.
In withdrawal syndrome in chronic alcoholism, it causes a decrease in agitation, tremors, negativism, as well as alcoholic delirium and hallucinations.
The therapeutic effect in patients with cardialgia, arrhythmia and raresthesia is observed by the end of the first week.
Indications for use
Anxiety disorders.
Dysphoria (as part of combination therapy as an additional drug).
Insomnia (difficulty falling asleep)
Spasm of skeletal muscles with local trauma; spastic conditions associated with damage to the brain or spinal cord (cerebral palsy, athetosis, tetanus); myositis, bursitis, arthritis, rheumatic pelvispondylitis, progressive chronic polyarthritis; arthrosis accompanied by tension of skeletal muscles; retebral syndrome, angina pectoris, tension headache.
Alcohol withdrawal syndrome: anxiety, tension, agitation, tremor, transient reactive states.
As part of complex therapy: arterial hypertension, gastric ulcer and duodenal ulcer; psychosomatic disorders in obstetrics and gynecology: climacteric and menstrual disorders, gestosis; epileptic status; eczema and other diseases accompanied by itching, irritability.
Meniere's disease.
Drug poisoning.
Premedication before surgical interventions and endoscopic manipulations, general anesthesia.
For parenteral administration: premedication before general anesthesia; as a component of combined general anesthesia; myocardial infarction (as part of complex therapy); motor agitation of various etiologies in neurology and psychiatry: paranoid-hallucinatory states; epileptic seizures (stopping); facilitation of labor; premature labor (only at the end of the third trimester of pregnancy); premature detachment of the placenta.
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Tizanidine (Tizanidine)
Tablets, capsules with modified release
Pharmacological action
Centrally acting muscle relaxant. Stimulates presynaptic alpha2-adrenoreceptors, which leads to inhibition of polysynaptic excitation transmission in the spinal cord, which regulates skeletal muscle tone.
Effective in acute painful muscle spasms and chronic spasms of spinal and cerebral origin. Reduces muscle rigidity during passive movements.
Indications for use
Painful muscle spasms caused by organic and functional disorders of the spine (cervical and lumbar syndromes, osteochondrosis, spondylosis, syringomyelia, hemiplegia), occurring after surgery (including for intervertebral disc herniation or osteoarthritis of the hip joint), spasticity of skeletal muscles in various neurological diseases (including multiple sclerosis, chronic myelopathy, degenerative diseases of the spinal cord, residual effects of stroke, TBI, cerebral palsy).
Tofisopam (Tofisopam)
Pills
Pharmacological action
"Daytime" anxiolytic (tranquilizer) from the benzodiazepine group. Also has anticonvulsant and central muscle relaxant effects. Enhances the inhibitory effect of GABA on the transmission of nerve impulses. Stimulates benzodiazepine receptors located in the allosteric center of postsynaptic GABA receptors of the ascending activating reticular formation of the brainstem and interneurons of the lateral horns of the spinal cord; reduces excitability of subcortical structures of the brain (limbic system, thalamus, hypothalamus), inhibits polysynaptic spinal reflexes.
The anxiolytic effect is due to the influence on the amygdala complex of the limbic system and is manifested in a decrease in emotional tension, weakening anxiety, fear, and restlessness. The sedative effect is due to the influence on the reticular formation of the brainstem and nonspecific nuclei of the thalamus and is manifested by a decrease in symptoms of neurotic origin (anxiety, fear). It has virtually no effect on productive symptoms of psychotic genesis (acute delusional, hallucinatory, affective disorders), and a decrease in affective tension and delusional disorders is rarely observed.
The anticonvulsant effect is achieved by enhancing pre-I synaptic inhibition, suppressing the spread of convulsive activity, but does not relieve the excited state of the lesion.
The central muscle relaxant effect is due to inhibition of polysynaptic spinal afferent inhibitory pathways (and to a lesser extent monosynaptic ones). Direct inhibition of motor nerves and muscle function is also possible.
Indications for use
Neurosis, psychopathy (nervous tension, vegetative lability, fear), apathy, decreased activity: schizophrenia, manic-depressive syndrome, pathocharacterological development of personality, reactive depressive state, climacteric syndrome, cardialgia, chronic alcoholism, alcohol withdrawal syndrome. delirium: myasthenia, myopathy. neurogenic muscular atrophy and other pathological conditions with secondary neurotic symptoms, in which anxiolytics with a pronounced muscle relaxant effect are contraindicated.
Attention!
To simplify the perception of information, this instruction for use of the drug "Use of adjuvants in the treatment of back pain" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.