Opioids Not Beneficial for Pain Relief in Acute Low Back, Neck Pain

MONDAY, July 3, 2023 (HealthDay News) -- For acute nonspecific low back pain or neck pain, opioids do not confer benefits compared with placebo, according to a study published online June 28 in The Lancet.

Caitlin M.P. Jones, Ph.D., from the University of Sydney, and colleagues recruited adults presenting to one of 157 primary care or emergency department sites within 12 weeks or less of low back or neck pain (or both) of at least moderate severity. Participants were randomly assigned to guideline-recommended care plus an opioid (oxycodone-naloxone, up to 20 mg oxycodone per day orally) or guideline-recommended care and an identical placebo for up to six weeks. The primary analysis included 151 participants in the opioid group and 159 in the placebo group.

The researchers found that pain severity for each group was not different at six weeks: 2.78 and 2.25 in the opioid and placebo groups, respectively (adjusted mean difference, 0.53; 95 percent confidence interval, −0.00 to 1.07; P = 0.051). At least one adverse event was reported by 35 and 30 percent of participants in the opioid and placebo groups, respectively; more people in the opioid group reported opioid-related adverse events (e.g., constipation in 7.5 versus 3.5 percent).

"There is no evidence that opioids should be prescribed for people with acute nonspecific low back pain or neck pain," the authors write.

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