Clonazepam for pain due to muscle spasm in a patient with vertebral compression fractures caused by multiple myeloma: a case report

Kazuki Akita,Emi Nakajima,Yasutomo Kumakura,Hiroki Ishiguro,Tetsuya Iijima

doi:10.1186/s40981-021-00477-1

Kazuki Akita, Emi Nakajima + Show 3 more

Open Access

https://doi.org/10.1186/s40981-021-00477-1

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Abstract

BackgroundVertebral compression fractures can cause severe back pain. Although many types of analgesics and interventional treatments are available, they are sometimes ineffective in mitigating the pain. We encountered a case where clonazepam was effective for the management of severe low back pain caused by lumbar vertebral compression fractures.Case presentationA 44-year-old male was diagnosed with multiple myeloma and had vertebral compression fractures of the first and second lumbar vertebrae. He had been suffering from severe low back pain on movement with muscle spasm and pain-associated anxiety. We considered this breakthrough low back pain to be caused by facet joint pain; thus, we prescribed clonazepam as a muscle relaxant and anxiolytic. Following this treatment, the intractable breakthrough pain was dramatically relieved.ConclusionClonazepam, which has both muscle relaxant and anxiolytic effects, might be helpful in mitigating pain, associated anxiety, and muscle spasms due to vertebral compression fractures.

Highlights

Vertebral compression fractures can cause severe back pain
Several types of analgesics and interventional treatments are used for severe low back pain associated with Vertebral compression fracture (VCF); it is difficult to provide adequate pain relief to these patients
balloon kyphoplasty (BKP) is more effective and safe compared to conservative treatment for pain caused by VCF due to osteoporosis and malignant diseases [9, 10]

Summary

Introduction

Vertebral compression fractures can cause severe back pain. many types of analgesics and interventional treatments are available, they are sometimes ineffective in mitigating the pain. Conclusion: Clonazepam, which has both muscle relaxant and anxiolytic effects, might be helpful in mitigating pain, associated anxiety, and muscle spasms due to vertebral compression fractures. VCFs cause severe low back pain in some cases, which lead to a decline in activities of daily living. Several types of analgesics and interventional treatments are used for severe low back pain associated with VCFs; it is difficult to provide adequate pain relief to these patients.

Results

Conclusion