• Clin J Pain · Jun 1999

    Clinical Trial

    Long-term opioid analgesic therapy for severe refractory lumbar spine pain.

    • J Schofferman.
    • SpineCare Medical Group, San Francisco Spine Institute, Daly City, California 94015, USA.
    • Clin J Pain. 1999 Jun 1;15(2):136-40.

    ObjectivesTo determine the effect of opioid analgesics on pain and function in patients with severe, refractory low back pain and to see if any benefits were sustained long term.DesignLongitudinal evaluation was conducted in two stages. Stage I was an opioid trial, and stage II was long-term treatment. Treated patients were compared with dropouts and trial failures.Outcome MeasuresPain was measured by the Numerical Rating Scale (NRS) and function was measured by the Oswestry Low Back Disability Score (OSW). Outcomes were evaluated by patient questionnaire and therefore not subject to investigator bias.SettingPrivate office practice.MethodsPatients were treated for 6-12 weeks with a long-acting or sustained-release opioid. Those who improved significantly were treated long term. The treatment group was compared with dropouts and failures.ResultsThirty-three patients underwent opioid trial. Treatment was discontinued because of intolerable side effects in 5 patients. In the remaining 28, mean NRS improved from 8.6 to 5.9 (p < 0.001), and mean OSW improved from 64 to 54 (p < 0.001). There were 21 patients treated long term (mean, 32 months). NRS improved from 8.45 to 4.90 (p < 0.001), and OSW improved from 64 to 50 (p < 0.001). Two patients returned to work. The changes in pain and function in the treatment group were significantly better than the comparison group. There was no drug diversion, addictive behavior, or organ toxicity. Doses remained stable.ConclusionLong-term opioid analgesic therapy is reasonable treatment for some well-selected patients with refractory low back pain who have failed all other forms of care.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…