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The treatment of low back pain (LBP) is still challenging, providing an opportunity to analyze new therapeutic approaches. N-acetylcysteine (NAC) seems promising in the management of LBP. Our case report describes, for the first time, two cases of women with LBP, both aged 62, participating in the same conventional physiotherapy program, but one of them used oral NAC (200 mg/day for 8 weeks) in combination with physiotherapy. NAC+physiotherapy was more effective in improving pain and Roland-Morris Disability Questionnaire and Oswestry Disability Index (ODI) scores, but did not alter Timed Up and Go Test (TUGT) scores. NAC had no adverse effects and did not modify alanine aminotransferase (ALT), aspartate aminotransferase (AST) and creatinine levels or total blood cell count. NAC showed a strong negative correlation with ODI, TUGT, AST and eosinophils, but a positive correlation with lymphocytes. NAC seems to have potential as an adjunct therapy in the management of LBP.
