Are Opioids Needed to Treat Chronic Low Back Pain? A Review of Treatment Options and Analgesics in Development

Journal of Pain Research
Jeffrey GudinSamyadev Datta

Abstract

The continued prevalence of chronic low back pain (CLBP) is a testament to our lack of understanding of the potential causes, leading to significant treatment challenges. CLBP is the leading cause of years lived with disability and the fifth leading cause of disability-adjusted life-years. No single non-pharmacologic, pharmacologic, or interventional therapy has proven effective as treatment for the majority of patients with CLBP. Although non-pharmacologic therapies are generally helpful, they are often ineffective as monotherapy and many patients lack adequate access to these treatments. Noninvasive treatment measures supported by evidence include physical and chiropractic therapy, yoga, acupuncture, and non-opioid and opioid pharmacologic therapy; data suggest a moderate benefit, at most, for any of these therapies. Until our understanding of the pathophysiology and treatment of CLBP advances, clinicians must continue to utilize rational multimodal treatment protocols. Recent Centers for Disease Control and Prevention guidelines for opioid prescribing recommend that opioids not be utilized as first-line therapy and to limit the doses when possible for fear of bothersome or dangerous adverse effects. In combination with the c...Continue Reading

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Citations

Mar 18, 2021·Translational Research : the Journal of Laboratory and Clinical Medicine·Joseph B O'Brien, David L Roman
Dec 24, 2021·Expert Review of Clinical Pharmacology·Michael HarrisMikael H Sodergren

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