We would like to express our congratulations to Sharifi et al for their recently published randomised, double-blinded clinical trial comparing methocarbamol to diazepam in the treatment of acute back pain in the ED.1 Although skeletal muscle relaxants (SMR) are frequently (and controversially) used in the treatment of low back pain (LBP), there has been a paucity of data to suggest their clinical benefit.2 To our knowledge, this is one of the first investigations that demonstrates the efficacy of both methocarbamol and diazepam for the treatment of LBP in an acute care setting. Given the clinical challenges of treating …