Opioid Drugs Provide Minimal Relief for Back Pain Patients

Highlights

• Back pain is the most commonly reported pain condition by patients.
• Opioid drugs provide limited relief for back pain.
• Patients are more worried about opioid addiction and side effects during treatment according to a research presented by American Society of Anesthesiologists (ASA).
• Combining a number of treatment options can be useful in providing back pain relief.

Opioid drugs which are commonly prescribed for the treatment of chronic back pain were found to provide only limited relief since patients complain of the side effects that are associated with these drugs while taking them. The research study was presented by the American Society of Anesthesiologists (ASA) at the Anesthesiology 2016 annual meeting.

Chronic back pain is the leading cause of pain in America. Around 26 million people between 20 - 64 years of age complain about recurrent back pain.

The National Institute of Health Statistics Survey also indicated that back pain was found to be the most commonly reported pain condition by patients.

Research Study on Opioid Use for Back Pain Relief

A survey conducted on the treatment options for low back pain was completed using 2030 patients. The research study focusing on the number of people who took opioids for treatment and their success rate in relieving back pain was determined.

Almost half of the patients (941 patients) were found to take opioids to treat back pain, out of which only 13% of the patients reported the treatment option to be very successful. 44% mentioned it to be ‘somewhat successful’ and 31% of patients answered ‘moderately successful’ and the remaining 12% of the patients said ‘not successful’.

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Opioid drugs are addictive and 75% of the patients reported side effects like constipation (65%), drowsiness (37%), memory or cognitive problems (32%) and dependence (29%).

Patients were also more concerned about the stigma associated with opioid drugs. Around 41% of the patients complained that they were more judged by using opioids. While only 19% from the 68% patients who took antidepressant drugs felt a stigma.

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Narcotic painkillers were found to cause serious risk of addiction and a major pharmaceutical company has recently agreed not to approve opioids for off-label uses such as long term back pain.

There was a lack of solid studies that prove the effectiveness of opioids in treating back pain which lasts for more than 12 weeks.

Asokumar Buvanendran, M.D., lead author of the study, director of orthopedic anesthesia and vice chair for research at Rush University, Chicago, and vice chair of the American Society of Anesthesiologists (ASA) Committee on Pain Medicine said "Patients are increasingly aware that opioids are problematic, but don't know there are alternative treatment options."

"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." he added.

The author also suggested that patients who have chronic low back pain for more than 3 months should consult a pain medicine specialist who combines a number of treatment methods which include physical therapy, interventional procedures like nerve blocks, bracing, nerve ablation techniques or implantable devices to reduce pain, anti-inflammatory medications and alternative therapies such as massage and biofeedback therapies for benefits.

Effect of Opioids on Back Pain:

Opioids are narcotic drugs which can help in the treatment of pain. These drugs mainly act by working on the pain receptors located in the brain. Opioids block the action of pain receptors and suppresses the pain perception.

Some of the opioid drugs include:

• Hydrocodone
• Morphine
• Tramadol
• Fentanyl
• Methadone
• Oxycodone
These drugs may produce minimal effect in relieving back pain and may result in a number of common side effects like addiction, constipation, drowsiness, abdominal pain and breathing difficulties.

It is advisable not to take opioid drugs for more than three months if there is a persistent back pain.

Facts on Back Pain:

• Back pain is a common problem which affects around 8 out of 10 people
• Commonly affects people who are between the age of 30- 40 years.
• People with poor physical fitness are more prone for back pain.
• Spondylitis - spinal arthritis which causes back pain is hereditary.
• Smoking is a factor that can prolong back pain healing
• Nature of Work - People who lift heavy weights by twisting their spine, or people who sit for a long time at the desk are subjected for back pain.

Preventive Measures for Back Pain:

• Follow regular exercises to keep the muscles strong
• Maintain a proper weight
• Avoid lifting heavy weight
• Maintain a proper posture
• Avoid Smoking
• Reduce Stress and have a good amount of sleep.

References:

1. What Is Back Pain? - (http://www.niams.nih.gov/health_info/back_pain/back_pain_ff.asp)
2. Back Pain - (https://medlineplus.gov/backpain.html)
3. Taking narcotics for back pain - (https://medlineplus.gov/ency/patientinstructions/000413.htm)
4. Medications for back pain - (https://medlineplus.gov/ency/article/007486.htm)
5. AAPM Facts and Figures on Pain - (http://www.painmed.org/patientcenter/facts_on_pain.aspx)

Source-Medindia