Can a Medrol (methylprednisolone) dose pack help with lumbago muscle spasms?

From the Guidelines

A Medrol (methylprednisolone) dose pack is not recommended for treating lumbago muscle spasms due to lack of evidence showing its effectiveness over placebo. The American College of Physicians and the American Pain Society guideline 1 states that systemic corticosteroids, such as methylprednisolone, are not recommended for treatment of low back pain with or without sciatica because they have not been shown to be more effective than placebo.

Some key points to consider when managing lumbago muscle spasms include:

• Nonpharmacologic therapies with proven benefits, such as spinal manipulation for acute low back pain, and intensive interdisciplinary rehabilitation, exercise therapy, acupuncture, massage therapy, spinal manipulation, yoga, cognitive-behavioral therapy, or progressive relaxation for chronic or subacute low back pain, should be considered 1.
• Herbal therapies, such as devil's claw, willow bark, and capsicum, may be safe options for acute exacerbations of chronic low back pain, but benefits range from small to moderate 1.
• Benzodiazepines and skeletal muscle relaxants may provide short-term pain relief, but are associated with risks for abuse, addiction, and tolerance, and are not FDA-approved for treatment of low back pain 1.

It's essential to prioritize nonpharmacologic therapies and other evidence-based treatments for managing lumbago muscle spasms, rather than relying on systemic corticosteroids like methylprednisolone, which lack strong evidence supporting their effectiveness for this condition.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION The initial dosage of methylprednisolone tablets may vary from 4 mg to 48 mg of methylprednisolone per day, depending on the specific disease entity being treated. The FDA drug label does not answer the question.

From the Research

Medrol Dose Pack for Lumbago Muscle Spasms

• A Medrol (methylprednisolone) dose pack is a type of corticosteroid used to treat various conditions, including inflammation and pain.
• There is limited direct evidence on the use of a Medrol dose pack specifically for lumbago muscle spasms.
• However, studies have investigated the use of methylprednisolone in treating low back pain and muscle spasm:
  • A study published in 2007 2 compared the effectiveness of 80 mg versus 40 mg methylprednisolone in epidural steroid injections for lumbar radicular pain, finding that both doses provided comparable pain relief.
  • Another study from 2011 3 used methylprednisolone injections to treat sacroiliac joint pain after lumbar spine surgery, resulting in significant pain relief for patients.
• Other treatments for acute low back pain and muscle spasm have been studied, including:
  • Cyclobenzaprine and naproxen combination therapy, which was found to be effective in reducing muscle spasm and pain in a 1990 study 4.
  • Methocarbamol, a muscle relaxant, which was shown to be effective in treating acute low back pain associated with myofascial components in a 2015 study 5.
• It is essential to note that high-dose methylprednisolone may cause myopathy in acute spinal cord injury patients, as reported in a 2005 study 6.
• In conclusion is not allowed, so:

Important Considerations

• The use of a Medrol dose pack for lumbago muscle spasms should be discussed with a healthcare professional to determine the best course of treatment.
• Patients should be aware of the potential benefits and risks associated with corticosteroid treatment, including the possibility of myopathy.
• Further research is needed to fully understand the effectiveness of Medrol dose packs in treating lumbago muscle spasms.