Study Evaluates Opioids for Chronic Back Pain Treatment

Understanding Chronic Back Pain

Chronic back pain is a complex and serious condition that impacts over 50 million Americans. Defined as pain lasting more than three months, chronic back pain remains a poorly understood and challenging issue to manage, despite extensive research efforts. The exact origins of chronic back pain are still unclear, with risk factors including aging, obesity, physical fitness, and previous injuries.

Opioid Prescription Trends

Approximately one in five individuals with chronic back pain receives an opioid prescription. Common opioid medications include morphine, hydrocodone, and oxycodone. While these drugs may provide temporary relief from pain, their addictive nature and questionable long-term effectiveness raise concerns about their use in chronic pain management.

Recent Research Findings

A study published in JAMA investigated the effectiveness of opioid medications over a 12-month period in enhancing pain-related function, pain intensity, and adverse effects. The research involved 240 patients who were prescribed either immediate-release opioids (morphine, oxycodone, and acetaminophen) or non-opioid medications (paracetamol and nonsteroidal anti-inflammatory drugs). Participants were recruited from US Veterans Affairs Primary Care Clinics between 2013 and 2015, with funding provided by the US Department of Veterans Affairs Health Services Research and Development Service.

Results of the Study

After one year of treatment, the researchers found no significant difference in pain-related function between the opioid and non-opioid groups. Additionally, patients taking opioids experienced more medication-related symptoms, while the side effects were similar across both groups. Notably, those receiving non-opioid treatments reported a greater reduction in pain intensity.

Conclusion and Recommendations

The findings suggest that opioids do not offer an advantage over non-opioid medications in the management of chronic back pain. Further studies are needed outside the Veterans Care Centre to determine the effects on a broader population.

Reference

Krebs E.E., Gravely A., Nugent S., et al. Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial. JAMA. 2018;319(9):872–882. DOI 10.1001/jama.2018.0899.