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Opioids are one of the types of pain relievers that are commonly prescribed to relieve back pain and neck pain. But a new study in the journal lancet has been published, showing that opioids do not relieve acute back or neck pain (lasting up to 12 weeks) and can instead exacerbate the pain.
Prescribing opioids for back pain and neck pain can also lead to common side effects such as nausea, constipation, and dizziness, as well as problems such as abuse, dependence, toxicity, and death. According to the website conversationThe findings of the new study show that opioids should not be recommended for the treatment of back pain and neck pain.
Comparison of opioids with placebo
In their trial, the researchers randomly assigned 347 people with neck pain and acute back pain to the opioid group (oxycodone plus naloxone) or the placebo group (a similar-looking pill that lacked the active ingredients). Oxycodone is an orally administered pain reliever. Naloxone is a drug that reduces some of the effects of opioids, such as the severity of constipation, but does not counteract the pain-relieving effects of oxycodone. Participants took opioids or a placebo for up to six weeks.
People in both groups received advice from their treating physician about returning to normal activities and avoiding long rest. The researchers evaluated the condition of the patients over a period of one year.
After six weeks of treatment, opioids did not provide more pain relief than placebo. Also, there was no advantage in terms of physical performance, quality of life, recovery time or absenteeism. More people in the opioid-treated group experienced nausea, dizziness, and constipation compared to the placebo group.
The long-term harms of opioid use were evident even with short-term use of these drugs. Compared to the placebo group, those in the opioid group experienced worsening pain and reported a higher risk of drug abuse (thinking, mood, or behavior problems, or using opioid medications in a different way than prescribed).
Significance of the results in terms of prescribing opioids
In recent years, international guidelines for the treatment of low back pain have shifted from a focus on drug-based treatment to non-pharmacological treatments, as evidence shows little therapeutic benefit and concerns about drug-related harms.
The guidelines provided by experts for the treatment of acute back pain include educating and counseling the patient and, if necessary, prescribing anti-inflammatory drugs such as ibuprofen. Opioids are recommended only when other treatments have not worked or are not appropriate. In the recommendations related to the treatment of neck pain, the prescription of opioids is prohibited.
New research clearly shows that the benefits of opioids in people with acute back pain and neck pain do not outweigh their potential harm.
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