The study underscores a significant blind spot in the evidence around the prescribing of opioids for acute back pain, says Deyo, so much so that it's somewhat shocking a study like this hadn't been done sooner. "It's going to ruffle feathers, and I think there'll be a lot of controversy." "It's a well-designed trial," says Richard Deyo, a family medicine doctor and an emeritus professor at Oregon Health and Science University. already caution against using opioids as a first choice when treating patients with acute pain, but opioids can be recommended when those other forms of treatment are not working.
MY UNORTHODOX LIFE CAST HOW TO
The results are sure to stir up debate about how to treat patients who are dealing with bouts of acute back pain. That's compared to 10% in the placebo group. When participants were surveyed a year later to gauge whether they had certain risk factors for opioid misuse, 20% of those in the opioid group had a score indicating behaviors that a doctor would find problematic when prescribing opioids.
MY UNORTHODOX LIFE CAST SKIN
Naloxone, a drug used to treat overdoses, reverses the effects of opioids when given intravenously, under the skin or as a nasal spray, but not when given orally because it doesn't reach the blood supply, says McLachlan.Īnd the study showed that taking opioids appeared to confer additional risk. The opioid group received a combination of oxycodone and naloxone, a medication that had the effect of minimizing gastrointestinal side effects related to the opioids, particularly constipation, so that participants wouldn't realize they were in the treatment group. Participants didn't know if they were receiving the medication or a placebo. For this type of nonspecific pain, he says, "you can't really take an X-ray and say, 'This is the problem.' "
The study focused on acute-onset back pain, which can be caused by everything from twisting or turning awkwardly to how you sleep, says McLachlan. Patients were excluded from the study if they had serious spinal pathology, which could be related to injuries like a fracture, an illness, or a surgery, among other things. Patients who had new low back or neck pain for 12 weeks or fewer were recruited from more than 150 primary care clinics and emergency departments in Sydney, Australia, and randomly assigned to either the opioid group or the placebo group.
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The results of the new trial draw attention to an unexpected gap in our understanding of how well opioids work in the context of acute back pain. "We thought there would be some pain relief, but overall there was no difference." "It was quite a surprise to us," says Andrew McLachlan, dean of pharmacy at the Sydney Pharmacy School and an author on the study, which was published Wednesday in The Lancet. In a study of more than 340 patients suffering from low back or neck pain, a team of Australian researchers found there was no difference in pain severity after six weeks between those who received opioids versus a placebo sugar pill. If that's not doing the trick though, doctors may prescribe a short course of opioids, with the goal of relieving pain and improving a patient's function.īut the results of a rigorous clinical trial published Wednesday cast doubt on using opioids even in this situation. When these episodes of pain are acute and nonspecific - meaning there's no clear cause or explanation - it's generally advised to start off with everyday remedies like over-the-counter anti-inflammatories, and alternatives like heat therapy, massage or exercise. New research suggests that opioids may not make sense for treating certain kinds of acute back pain.īack and neck pain afflicts millions of American adults, driving many to seek relief from their family doctor or even the local emergency room. Back and neck pain affect millions of Americans.
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