Despite the risks associated with their use, opioids are commonly prescribed as standard treatment for acute back and neck pain.
The curious thing is that researchers have discovered that, compared to opioids, a placebo is more effective in reducing acute back and neck pain – in the short term. Yes, the placebo.
Lower back and neck pain is a global issue. Clinical guidelines recommend opioids, a class of drugs that mimic the pain-relieving properties of opium derived from the poppy plant, to be prescribed when other forms of analgesia are contraindicated or have not worked.
Despite these guidelines, millions of people receive opioids as a first-line treatment after experiencing lower back and neck pain.
According to the Centers for Disease Control and Prevention (CDC), in the United States, opioids were dispensed at a rate of 43.3 prescriptions per 100 people in 2020. In other words, 43 out of every 100 people take opioids.
Although opioids are effective in reducing pain, they can lead to adverse side effects such as dependence, abuse, and overdose. Furthermore, there is no solid evidence to support their effectiveness in treating acute back and neck pain.
A study conducted by researchers from the University of Sydney (Australia) has examined the short-term and long-term effectiveness and safety of opioid use for treating acute back and neck pain. This study is the first of its kind.
The researchers recruited 347 participants with acute lower back pain, acute neck pain, or both. For the study, “acute” was defined as at least moderate pain lasting for 12 weeks or less.
After being randomly assigned to receive either a placebo or the opioid oxycodone, up to 20 mg daily, for six weeks, the participants were followed up for 12 months.
Both groups received standard care, which included avoiding bed rest and staying active, and the intensity of pain was measured at six weeks.
The study found that at six weeks, participants who received opioids did not experience greater pain relief than those who took a placebo.
Even short-term use of an opioid did not provide benefits in reducing pain and caused a slight increase in pain in the medium and long term compared to the placebo. More people in the placebo group recovered within the first 14 days than those in the opioid group.
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