POEMs

Opioid Analgesia Hard to Tolerate and Not Effective for Chronic Low Back Pain

 

Am Fam Physician. 2016 Nov 1;94(9):753-757.

Clinical Question

Is opioid analgesic treatment effective in patients with low back pain?

Bottom Line

Effective pain control in patients with low back pain is still elusive. Approximately one-half of all patients with low back pain who take an opioid analgesic will stop treatment because of ineffectiveness or adverse effects. Patients staying the course will experience, on average, a small decrease in pain relative to patients who take placebo (similar to the benefit from nonsteroidal anti-inflammatory drugs) and will not have improved function. (Level of Evidence = 1a)

Synopsis

To identify randomized controlled trials that enrolled patients with nonspecific low back pain, published in any language, and evaluated an opioid analgesic, these researchers searched five databases

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.


 

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