Cyclobenzaprine extended release for acute low back and neck pain

Low back pain and neck pain are major public health problems in the USA [1]. In a 3‐month prevalence study conducted across the USA, more than 34 million (17%) adults reported low back pain alone, 9 million (4%) reported neck pain alone and 19 million (9%) reported both low back pain and neck pain, resulting in a 3‐month combined prevalence of 31% of adults [1]. Studies conducted elsewhere report similar prevalence estimates [2], and it is esti‐ mated that approximately 70% of all adults will experience back or neck pain at some point in their lives [1]. Low back pain and neck pain cause discomfort and disability, affecting an individ‐ ual’s capacity to perform routine daily activities and imposing work limitations. The cost of low back and neck pain is consid‐ erable. Studies conducted in the 1990s give esti‐ mates of direct costs in the USA ranging from US$12.2 billion to US$90.6 billion [3]. The most recent study of direct medical costs in the USA estimated that the incremental cost of spinal problems per patient in 2005 was US$2580 (95% confidence interval [CI]: US$2404–2757), giving a total direct cost of US$85.9 billion (95% CI: US$80.1–91.8 billion) [4]. Indirect costs in the USA have been estimated as being between US$7.4 billion (the most recent estimate in 2004) and US$28.2 billion (in 1996) [3].