Opioid drugs may not help with long-term low back pain

In the Journals

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Opioid painkillers are commonly prescribed for chronic low back pain. However, a review of 20 trials published online May 23, 2016, by JAMA Internal Medicine found the drugs offer only modest, short-term relief.

Thirteen placebo-controlled trials examined 3,419 people who used opioids, such as oxycodone (OxyContin) and tramadol (Ultram), to manage low back pain. The subjects rated pain on a scale of zero to 100 using a questionnaire. A difference of 10 points or lower on the scale was regarded as minimal, while a 20-point difference or higher was considered a meaningful effect.

Of the 20 trials, 17 compared opioids with a placebo, and three compared opioids with each other. The researchers found that among the placebo trials, opioids had a mean pain relief score of 10.1 for the short term (less than three months) and 8.1 for the intermediate term (three months to a year).

"If opioids are used for low back pain management, it appears they may need to be combined with nondrug therapies like physical therapy or a different drug," says lead researcher Dr. Christina Abdel Shaheed of Western Sydney University in Australia.

It also should be noted that the findings did not apply to people with identified causes of back pain, such as inflammatory conditions, infections, cancer, or trauma. Also, about half the people who took opioids experienced side effects, such as nausea, constipation, and headaches.