title: The effect of muscle relaxant on the paraspinal muscle blood flow: a randomized controlled trial in patients with chronic low back pain.
abstract: METHODS
  A randomized controlled trial.
  
  
  OBJECTIVE
  To investigate the effect of muscle relaxant for muscle blood flow at the trunk muscle in patients with chronic low back pain (LBP).
  
  
  BACKGROUND
  Paraspinal muscle function is widely believed to play a role and considered to be of etiologic significance in LBP, and intramuscular pressure increases and blood flow decreases in the flexion position. Decrease in oxygenated hemoglobin at the trunk muscle is seen in patients with LBP.
  
  
  METHODS
  A total of 74 male patients with LBP lasting more than 6 months were randomized to 3 treatment groups: (1) physical therapy only (control) (n = 25), (2) administration of eperisone hydrochloride (EMPP) for 4 weeks (n = 24), and (3) McKenzie therapy (n = 25). The primary outcome variables, observed at 2 and 4 weeks, are the Japanese Orthopedic Association LBP score, visual analogue scale (VAS), Faces Pain Scale-Revised, and SF-36. Intramuscular oxygenation was evaluated using near-infrared spectroscopy during lumbar extension and flexion, and oxygenated hemoglobin and deoxygenated hemoglobin were compared.
  
  
  RESULTS
  VAS was significantly lower at 4 weeks in the McKenzie group than in the control group. There were no significant changes at 2 weeks in all parameters, however, the relative change of oxygenated hemoglobin during lumbar extension at 4 weeks was significantly higher in the EMPP group when compared with the other 2 groups. The relative change of deoxygenated hemoglobin during lumbar flexion showed a significant difference at 4 weeks in the EMPP group when compared with the control group.
  
  
  CONCLUSIONS
  Administration of EMPP for 4 weeks improved the LBP in VAS, though not as effective as McKenzie therapy. Our data demonstrated the effects of eperisone hydrochloride on paraspinal muscle hemodynamics improving intramuscular oxygenation during lumbar extension and flexion in patients with chronic LBP.
authors.affiliation: Nagoya University School of Medicine, Orthopaedic Surgery, Nagoya, Japan. jsakai@med.nagoya-u.ac.jp
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Sakai
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Matsuyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakamura
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Katayama
authors.forename: Shiro
authors.initials: S
authors.lastname: Imagama
authors.forename: Zenya
authors.initials: Z
authors.lastname: Ito
authors.forename: Akira
authors.initials: A
authors.lastname: Okamoto
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiguro
mesh_terms: D000328:Adult; D002908:Chronic Disease; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000187:drug effects* / Q000502:physiology; D009465:Neuromuscular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods
chemical_list: D009465:Neuromuscular Agents