Gabapentinoids Ineffective for Low Back Pain

Evidence that gabapentinoids are effective for chronic low back pain (CLBP) is limited; however, existing findings may suggest that there are significant risks of adverse events, according to a new study published by PLOS Medicine.

"Despite their widespread use, our systematic review with meta-analysis found that there are very few randomized controlled trials that have attempted to assess the benefit of using gabapentin or pregabalin in patients of chronic low back pain," the authors wrote.

Gabapentinoids, such as pregabalin and gabapentin, are typically used to treat nerve pain, such as fibromyalgia, and can also treat seizures. The drugs are becoming common treatments for low back pain as an alternative to opioids and other analgesic drugs.

In the study, the authors analyzed the results from 8 randomized controlled trials that examined the use of gabapentinoids in adults with CLBP.

The authors found that gabapentin did not improve pain compared with placebo, according to the study.

In studies comparing pregabalin to other analgesics, the authors discovered it was less effective in terms of pain relief for patients with CLBP.

Although treating CLBP with gabapentinoids was not linked to hospitalization or deaths in the studies, the drugs were commonly linked to adverse events, such as dizziness, fatigue, confusion, and visual disturbances, according to the study.

The authors also noted that gabapentinoid use for CLBP was not found to significantly improve functional and emotional outcomes.

"The existing evidence does not support the use of gabapentinoids for predominant chronic low back pain, and calls for larger, high quality trials to more definitively inform this issue,” the authors concluded.

These new findings add to the mounting evidence that drug therapy for low back pain may not be the most effective treatment.

A recent study conducted by the National Institutes of Health (NIH) also indicated that drug-based approaches to pain treatment may be ineffective. Instead, the NIH outlined several approaches to treating various types of pain. For patients with back pain, the researchers found strong evidence that acupuncture and yoga could relieve pain.