Millions of people take opioids for chronic back pain, but new research shows that many of them get limited relief while experiencing side effects. They also worry about the stigma associated with taking the painkillers.
More than 100 million people in the United States suffer from chronic pain, and those with chronic low back pain are more likely than patients with other types of pain to be prescribed opioids. Unfortunately, these medications are addictive and can cause side effects, ranging from drowsiness to breathing problems.
“Patients are increasingly aware that opioids are problematic, but don’t know there are alternative treatment options,” said Asokumar Buvanendran, M.D., director of orthopedic anesthesia and vice chair for research at Rush University in Chicago, and lead author of the study, which was presented at the ANESTHESIOLOGY 2016 annual meeting.
“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.”
For the study, 2,030 people with low back pain completed a survey about treatment. Nearly half — 941 — were currently taking opioids. When asked how successful the opioids were at relieving their pain, only 13 percent said “very successful.” The most common answer — given by 44 percent — was “somewhat successful” and 31 percent said “moderately successful.” About 12 percent said “not successful.”
Additionally, 75 percent said they experienced side effects, including constipation (65 percent), sleepiness (37 percent), cognitive issues (32 percent), and dependence (29 percent).
They also had concerns about the stigma associated with taking opioids. According to the study’s findings, 41 percent said they felt judged by using opioids. While 68 percent of the patients had also been treated with antidepressants, only 19 percent felt a stigma from using those.
A pharmaceutical company recently agreed to disclose in its promotional material that narcotic painkillers carry serious risk of addiction and not to promote opioids for unapproved, “off-label” uses such as long-term back pain. Researchers also noted a lack of solid studies on the effectiveness of opioids in treating back pain beyond 12 weeks.
Patients with chronic low back pain — described as persistent pain lasting more than three months — should see a pain medicine specialist who uses an approach that combines a variety of treatments that may be more beneficial, said Buvanendran.
These treatments include physical therapy, bracing, interventional procedures such as nerve blocks, nerve ablation techniques or implantable devices, other medications such as anti-inflammatories and alternative therapies such as biofeedback and massage, he said.