Evidence lacking for long-term opioid use in low back pain

April 16, 2014
Evidence lacking for long-term opioid use in low back pain

(HealthDay)—There is evidence of short-term efficacy (moderate for pain and small for function) of opioids for treatment of chronic low back pain (CLBP) compared with placebo; however, the effectiveness and safety of long-term opioid therapy for treatment of CLBP remains unproven, according to a review published in the April 1 issue of Spine.

Luis Enrique Chaparro, M.D., from Hospital Pablo Tobon Uribe in Medellin, Columbia, and colleagues updated a 2007 Cochrane Review to assess the efficacy of opioids in adults with CLBP. Randomized controlled trials (through October 2012) assessing the use of noninjectable opioids in CLBP for at least four weeks versus or other treatments were included. However, comparisons of different opioids were excluded.

The researchers found that 15 trials (5,540 participants), including twelve new trials, met the criteria. Compared to placebo, tramadol was better for pain and function, while transdermal buprenorphine decreased pain, compared to placebo, but did not affect function. Broadly, strong opioids (including morphine, hydromorphone, oxycodone, oxymorphone, and tapentadol) were better for pain and function than placebo. There was no difference between opioids and antidepressants for pain or function in two trials (272 participants). There were no reports of serious adverse effects, risks (addiction or overdose), or complications (sleep apnea, opioid-induced hyperalgesia, hypogonadism). Quality of the trials was low to moderate and the trials also had high dropout rates, short duration, and limited interpretability of functional improvement.

"There is evidence of short-term efficacy (moderate for and small for function) of to treat CLBP compared with placebo," the authors write.

Relevant financial activities outside the submitted work were reported: board membership, consultancy, honoraria, employment, and royalties

Explore further: Men taking long-acting chronic pain meds five times more likely to have low testosterone levels

More information: Full Text

Related Stories

Single-question low back pain severity assessment accurate

February 5, 2013

(HealthDay)—Patient-reported chronic low-back pain (CLBP) severity, based on answering a single question, provides an accurate indicator of patient-reported health status, according to a study published in the February ...

BMI not linked to pain after exercise rehab for back pain

December 12, 2013

(HealthDay)—For individuals with chronic low back pain (cLBP), body mass index (BMI) is not significantly associated with self-reported pain and disability, according to a study published in the Dec. 1 issue of Spine.

Recommended for you

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.