Australian researchers have found no evidence that opioids are more effective than placebos in managing lower back pain in middle-aged individuals.
The research was carried out at the University of Sydney. It included nearly 350 participants with a median age of 44. These participants, who were suffering from either lower back or neck pain, were selected from primary care clinics and emergency departments. The researchers randomly assigned them to receive either opioids or a placebo for their pain.
The Unexpected Findings
Throughout the six-week treatment period, the pain levels reported by participants didn’t show any significant difference. What surprised the researchers was that the placebo group reported slightly lower pain intensity than the opioid group. The placebo group also showed a slight advantage in measures of physical functioning and quality of life, although the difference wasn’t statistically significant.
The people who participated in the study didn’t suffer from any severe medical problems, such as fractures. They also had no previous history of back pain.
Compliance and Adherence
Despite the instructions, only about 58% of the participants fully adhered to the prescribed regime of either the opioid or placebo. The research team excluded patients who didn’t provide adequate follow-up results from the final analysis.
Implications and Recommendations
Professor Andrew McLachlan, co-author of the research and dean of Sydney Pharmacy School commented on the study’s findings. He stressed the need to shift focus to other treatment methods for lower back pain.
He recommended staying active as part of pain management, applying heat, and using anti-inflammatory medicines when possible. For those currently relying on opioids for pain management, he urged them to consult with their doctor or pharmacist before abruptly discontinuing their medication.
A Global Relevance
Although researchers conducted the study in Australia, its implications reverberate globally. This is especially true in the U.S, where opioid overdoses have led the causes of deaths across all age groups since 2016. In Asia, the findings can aid in guiding medical practitioners towards more effective, less risky treatment strategies.
A Medical Perspective
From a medical standpoint, these findings hold significant implications for pain management strategies. The lack of a notable difference between opioids and placebos in treating mid-40s lower back pain could mean a potential shift in prescribing patterns, particularly given the inherent risks associated with opioid use.
This study aligns with the increasing recognition within the medical community that long-term opioid therapy for chronic non-cancer pain may be less beneficial than previously thought.
Further, given there is an ongoing opioid crisis in the U.S but also growing in parts of Asia. Therefore, this research provides important evidence to inform a more cautious approach to opioid prescribing.
In conclusion, managing low back pain, particularly in the mid-40s age group, might require a broader focus. This can be centered on lifestyle changes, physical therapies, and non-opioid pharmaceutical options. The findings of this study still needs further validation. If true, it can be a crucial part of the conversation in the global quest to manage pain more effectively and safely.