Effects of Metformin on Low Back Pain

Inclusion Criteria:

• Age 18 and above

• Diagnosed with axial low back pain (low back pain more severe than pain in otherparts of the body, without radiation of pain into the lower extremities).

• Women of child bearing potential must have a negative serum pregnancy test atbaseline.

Exclusion Criteria:

• Diagnosed with rheumatoid arthritis, lupus, other autoimmune/systemic inflammatoryarthropathies

• Progressive lower extremity weakness or numbness

• Recent oral steroid use (within last 3 months)

• NSAID use

• Chronic kidney disease (eGFR <60)

• Diagnosis of diabetes mellitus

• Subjects must not be pregnant or breastfeeding, or planning to become pregnant orbreastfeed during the course of the trial

• Unable to take an oral medication in a non crushable pill form

• Taking metformin presently or within the last 6 months

• History of allergy to metformin

• History of lactic acidosis

• Severe Hepatic dysfunction

• Currently taking a diabetic medication such as sitagliptin, saxagliptin,linagliptin, alogliptin, sitagliptin with metformin

• Currently taking a Carbonic anhydrase inhibitor such as topiramate, zonisamide,acetazolamide, dichlorphenamide, methazolamide

• Currently taking cimetidine