Opioids Compared With Placebo or Other Treatments for Chronic Low Back Pain

Abstract

There is evidence of short-term efficacy (moderate for pain and small for function) of opioids to treat CLBP compared with placebo. The effectiveness and safety of long-term opioid therapy for treatment of CLBP remains unproven.

The Crisis of Medicine and the Benefits of Complex Pain Therapy Procedures Such As Cupping: More Research Needed

“…For example, long-term effects of opioids in chronic low back pain (LBP) are unclear, the dependence of patients on opioids for back pain is up to 24%, according to the authors of a systematic review [8]. The authors of a Cochrane up-date came to the same conclusion: while there is evidence of short-acting efficacy of opioids in chronic LBP, the efficacy and safety of long-term therapy has not been demonstrated [9]. The opioid crisis gives reason to think about the role of science [10], new development of drugs, the medical system as a whole, but also in a positive outlook, about the use of non-pharmacologic interventions for chronic pain diseases [11], because non-steroidal anti-inflammatory drugs could also have severe and sometimes fatal side effects [12].…”

Reflexiones sobre el uso de opioides en dolor lumbar

“…Dos revisiones sistemáticas recientes de alta calidad han demostrado que, debido a la falta de ensayos, existen dudas respecto a la eficacia de los analgésicos opioides para los pacientes con dolor lumbar agudo (6) y también cuando estos medicamentos se utilizan a largo plazo para el dolor lumbar crónico (7). También hay incertidumbre en cuanto a la dosificación óptima de los analgésicos opioides ya que, hasta donde sabemos, no ha habido una evaluación sistemática de cómo la dosis de estos medicamentos pueden influir en el tamaño de cualquier efecto del tratamiento para las personas con dolor lumbar (8,9). Por otro lado, la capacidad de estos pacientes con dolor lumbar para tolerar los analgésicos opioides no está bien estudiada.…”

Persistent analgesic use and the association with chronic pain and other risk factors in the population—a longitudinal study from the Tromsø Study and the Norwegian Prescription Database

“…The long-term effectiveness/efficacy of analgesics remains for the most part unproven [6][7][8]. Adverse effects are on the other hand well known and are particularly associated with nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids [1,9,10].…”