Narcotics Offer Only Short-Term Relief of Back Pain

FOR IMMEDIATE RELEASE
(Free-Press-Release.com) January 21, 2007 -- Potent opioid drugs, such as Oxycontin and Vicodin, may help treat chronic back pain in the short term, but it's not clear the drugs help in the long run and abuse may be common, a new review has found.

"Opioids may be effective for short-term relief," said study author Dr. Bridget A. Martell. "But all studies [reviewed] were less than four months."

Martell and her colleagues did what is known as a meta-analysis, pooling the results of 38 previously published studies. "The meta-analysis does not show statistical significance that opioids work any better than placebo," she said, although "they possibly work for short-term relief."

The new report is published in the Jan. 16 issue of the Annals of Internal Medicine.

"This is the first meta-analysis to look at opioids for chronic back pain," Martell said. She conducted the study while an associate research scientist at Yale University and wrote the report while she was associate director of the Pfizer New Haven Clinical Research Unit, part of the pharmaceutical company's Global Research and Development Division.

Martell's team found that the prescription of these drugs varied by treatment settings, with the percentage of patients prescribed the drugs for chronic back pain ranging from 3 percent to 66 percent.

Prescribing them was most likely if patients went to a specialty treatment center and least common in primary-care centers.

Included in the reviewed studies were five reports that looked at "suspicious" medication-taking behaviors that would make health-care providers suspect abuse, such as ordering refills before they are needed. These behaviors occurred in up to 24 percent of cases.

Back pain is the second leading symptom seen by physicians in the United States, according to Martell. Chronic back pain is defined as discomfort lasting more than three months. It afflicts up to 19 percent of working adults, Martell wrote.

Besides narcotic medication, physicians can treat chronic back pain in other ways, using exercise, nonsteroidal anti-inflammatory medicines (NSAIDs), tricyclic antidepressants, acupuncture and electrical stimulation.

Based on the analysis, Martell offers this advice to patients with chronic back pain: "Consider all your options carefully, weigh the risks vs. the benefits of those options, and be sure to seek specialty care from a pain specialist."

Dr. Andrew Sherman, head of spine and musculoskeletal rehabilitation at the Spine Institute at the University of Miami Miller School of Medicine, agreed. "This meta-analysis suggests that significant risks do exist with the use of opioid medicines," he said. "Patients need to consult with a board-certified expert physician in pain management."

The lack of high-quality scientific studies is another important issue, Sherman said. The researchers found 2,378 studies but discarded most because they didn't meet the standards of their meta-analysis.

source: http://health.msn.com/