In people presenting with low back pain, nucleotides combined with vitamin B12 demonstrate superior pain reduction at 30 days when compared to the combination of vitamins B1, B6, and B12. But, both therapies offer equivalent pain relief at 60 days.

A study was conducted to evaluate the use of a combination of nucleotides (uridine [UTP] and cytidine [CMP]) and vitamin B12, vs. B-complex vitamins (B1, B6, and B12) for the management of low back pain.

The study involved a 60-day oral treatment, where participants were randomly assigned to Group A (n = 317), receiving nucleotides + B12, or Group B (n = 317), receiving B-complex vitamins. The incidence of adverse events (AEs) was the major outcome ascertained.

In this double-blind, randomized controlled trial, the secondary outcomes included pain scores using the visual analog scale (VAS) at Visit 2 (day 30) and Visit 3 (day 60) compared to baseline values, as well as improvements in the finger-to-floor distance (FFD) and Roland–Morris Questionnaire (RMQ) scores (percentage of volunteers per group with improvements of ≥3 points and ≥5 cm, respectively).

Out of the total participants, 75 (24%) in Group A and 105 (33%) in Group B experienced a total of 133 and 241 AEs, respectively. In Group B, 24 participants discontinued treatment due to AEs, while no AE-associated discontinuations were observed in Group A.  Both groups demonstrated clinically meaningful reductions in VAS scores after 30 and 60 days of intervention, with Group A exhibiting a greater reduction at Visit 2 (Figure 1).

At days 30 and 60 of the treatment period, both groups demonstrated improvements in effectiveness measures, including RMQ and FFD. RMQ score improvements of ≥5 points were observed in 99% of volunteers in both groups. Furthermore, all subjects demonstrated FFD improvements of ≥3 cm.

The nucleotides + B12 use was linked with  a reduced incidence of total AEs, fewer AEs per person, and no discontinuations due to AEs. After 30 days of treatment, the nucleotides + B12 group demonstrated superior pain intensity reduction compared to the B-complex vitamins group, while both groups exhibited equivalent pain reduction after 60 days of treatment.