Opiates are no better for pain relief than a placebo in acute back and neck pain. This is shown by an Australian study by Caitlin Jones et al. published in The Lancet.
The researchers randomized (1:1) 310 patients who visited the GP or the emergency department with back and/or neck complaints and received placebo tablets or oxycodone/naloxone tablets. Patients with an identifiable cause such as a fracture were excluded from participation. The tablets were used until patients rated the pain as 0 or 1 on a scale of 1 to 10 for three consecutive days. The tablets were continued for up to six weeks.
The researchers found that after six weeks, the opiate group had an average pain score of 2.78, while the placebo group had an average score of 2.25. This difference was not significant. After a year of follow-up, the secondary outcome measure, the placebo group even experienced less pain. However, patients in the opioid group more often suffered from opioid-related side effects, such as constipation and nausea, than in the placebo group (7.5 versus 3.5%).
Guidelines
The Dutch NHG Standard, among others, does not recommend prescribing opioids for acute back pain. However, research by the Level (2020) that opioids are still widely prescribed, possibly also for acute pain. That is why Professor of General Practice Bart Kroes (Erasmus MC), who participated in the study, calls in the press release to “state in the guidelines for the treatment of acute neck and back pain that these complaints are not an indication for an opioid.”
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2023-06-29 15:08:07
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