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Evidence summaries

Cyclobenzaprine for the Treatment of Myofascial Pain in Adults

There is insufficient evidence from controlled trials on the treatment of myofascial pain (MP) with cyclobenzaprine. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 2 studies with a total of 79 subjects. One study, with 41 participants, compared cyclobenzaprine with clonazepam and with placebo. Participants taking cyclobenzaprine had some improvement of pain intensity compared to those on clonazepam, mean difference (MD) -0.25 (95% CI -0.41 to -0.09; P value 0.002) and placebo, MD -0.25 (95% CI 0.41 to -0.09; P value 0.002). The other study, with 38 participants, compared cyclobenzaprine with lidocaine infiltration. Thirty days after treatment there were statistically non-significant differences between comparison groups, favoring lidocaine infiltration, for the mean for global pain, MD 0.90 (95% CI -0.35 to 2.15, P value 0.16), and for the mean for pain at digital compression, MD 0.60 (95% CI -0.55 to 1.75, P value 0.30). There were no life-threatening adverse events associated with the medications.

Comment: The evidence is downgraded by imprecise results (few studies and wide confidence intervals) and by indirectness (differences in reported outcomes). Both studies included used different diagnostic criteria for MP.

    References

    • Leite FM, Atallah AN, El Dib R, Grossmann E, Januzzi E, Andriolo RB, da Silva EM. Cyclobenzaprine for the treatment of myofascial pain in adults. Cochrane Database Syst Rev 2009 Jul 8;(3):CD006830. [PubMed]

Primary/Secondary Keywords