Research shows opioids ineffective for back, neck pain

A new study published this week has revealed that the widely prescribed medicines for back pain may not benefit people as "it has no efficacy in reducing pain".

Opioids are largely prescribed by professional healthcare experts for lower back pain and neck pain as an analysis of Global Burden of Disease Study 2021 data showed the former a leading contributor to years lived with disability.

If the pain persists for up to six weeks, it is termed acute, and if 12 weeks, it is defined as chronic.

Christine Lin, a professor at the Institute for Musculoskeletal Health at the University of Sydney and a lead author of the research, said: "Despite these guidelines and there being no evidence of their efficacy in reducing pain, opioid pain relievers are still widely prescribed for people with lower back and neck pain in many countries."

Scientists found that opioids weren’t any more helpful than the placebo, in the research published in the journal The Lancet.

People using opioids reported nausea, dizziness and constipation more than those who used the placebo.

"We also know that being prescribed opioid pain relievers even for a short period of time increases the risk of opioid misuse long term," Lin said.

Why opioids are not helpful in pain?

Experts also have their own theories about why opioids do not work in pain.

According to experts, one possibility is that people in the opioid group could have had other underlying factors than the authors noticed — ones known to respond poorly to opioid treatment.

Dr Mark D Sullivan and Dr Jane C Ballantyne, who weren't involved in the study said: "The pain treated might have been more chronic, recurring pain than the type caused by acute injury."

"Participants were only required to have a 1-month pain-free before their current episode of spinal pain," they wrote in a commentary.

"If many of these participants had recurrent pain, this might account for the non-response to opioid therapy."

Dr John Finkenberg, a San Diego-based specialist in orthopaedic spine surgery, said areas of pain in the neck and back sometimes need to be treated separately.

"If somebody had both of these going on, they, quite frankly, will have a systemic-type issue going on, whether it be general arthritis or rheumatoid. So we have to be careful on the patients that come in with both," added Finkenberg.

The lead author said doctors should not prescribe opioids, "instead, doctors should be encouraged to focus on patient-centred approaches that could include advice to stay active, and simple pain relievers.