By: 12 December 2016
Many back pain patients get limited relief from opioids and worry about taking them

A new study has revealed that many patients with chronic low back pain get limited pain relief from taking opioids. Patients also reported concerns about the long-term usage of opioid painkillers.

“Patients are increasingly aware that opioids are problematic, but don’t know there are alternative treatment options,” said Asokumar Buvanendran, director of orthopaedic anaesthesia and vice chair for research at Rush University, Chicago, and lead author of the study. “While some patients may benefit from opioids for severe pain for a few days after an injury, physicians need to wean their patients off them and use multi-modal therapies instead.”

In the study, 2030 people with low back pain completed a survey about treatment. Nearly half (941) were currently taking opioids. When asked how successful the opioids were at relieving their pain, only 13 per cent said they were “very successful”, while 75 per cent described their pain relief as only  “moderately” to “somewhat successful”. Twelve per cent of respondents said that opioids were not successful at giving pain relief.

Seventy-five per cent of those surveyed said that they had experienced side effects, including constipation (65 per cent), sleepiness (37 per cent), cognitive issues (32 per cent) and dependence (29 per cent).

Respondents also had concerns about the stigma associated with taking opioids, with 41 per cent saying they felt judged for using opioids. ALthough 68 percent of the patients had also been treated with antidepressants, only 19 per cent said they felt a stigma from using those.

A major pharmaceutical company recently agreed to disclose in its promotional material that narcotic painkillers carry serious risk of addiction and not to promote opioids for unapproved, “off-label” uses such as long-term back pain. The researchers also noted a lack of solid studies on the effectiveness of opioids in treating back pain beyond 12 weeks.

Source: American Society of Anesthesiologists