Opioids Ineffective for Many with Back Pain

Findings from a recent study suggest that while millions of patients take opioids for chronic back pain, some may experience limited relief and experience side effects, as well as worry about the stigma attached to opioids.

Chronic pain is a serious condition that has a variety of medical and non-medical treatment approaches. Prescription opioids are typical among patients with lower back pain, but these drugs come with serious side effects and an addiction risk.

“Patients are increasingly aware that opioids are problematic, but don't know there are alternative treatment options,” said lead study author Asokumar Buvanendran, MD. “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.”

The National Institutes of Health has even found that acupuncture and yoga were beneficial nondrug approaches to treating chronic back pain. The current study included 2030 patients with lower back pain who filled out a survey discussing their treatment.

There were 941 patients taking opioids, but only 13% said the treatment was “very successful.” Approximately 44% of the respondents said the treatment was “somewhat successful.”

Another 31% said the treatment was “moderately successful,” and 12% responded “not successful.”

Three-fourths of the respondents reported side effects, including 65% patients experiencing constipation, 37% experiencing sleepiness, and 32% reported problems with cognition. Dependence issues were also reported among 29% of respondents who experienced side effects, according to the study.

Many patients also said they were concerned with the stigma that comes with using prescription opioids, with 41% saying they felt judged because of it. Nearly 70% of patients treated with opioids had also been treated with antidepressants, and only 19% said they felt a stigma from those medications.

Recently, a large drug manufacturer announced that it did not condone using opioids for off label conditions, such as a long-term treatment for back pain. The researchers also said there has not been many studies that explore the efficacy of the drugs treating this condition after 12 weeks.

Patients with chronic pain lasting more than 3 months should see a specialist that who be able to create a more beneficial treatment approach. Other interventions such as physical therapy, bracing, nerve blocks, nerve ablation techniques, implantable devices, other medications, and alternative therapies could all be explored as a better long-term treatment for these patients, the study concluded.