Do pain meds help with chronic low back pain? That is a question that has been being asked quite a lot the past few years. Now that the addiction to opioids has turned into an epidemic that leads to heroin addiction, the question is more relevant than ever.
The New York Times editorial board recently issued an opinion piece, The Insanity of Taxpayer-Funded Addition1. It points outs that while the “epidemic now kills 50,000 Americans a year, the Trump administration wants to spend tens of millions of dollars in part to help the industry responsible sell ostensibly non-addictive pain medications and ‘abuse deterrent’ opioids that are as addictive as the original opioids.” From my view as a practitioner who works with people who have back pain, even if opioids are effective in the short term, they are not effective in the long term.
The NIH spent approximately $600 million for pain and opioid use in 2016. Whoa, that is some significant number. Is there a place for opioid use? Absolutely. Is it for long term back pain? No. So what else has the pharmaceutical world been encouraging doctors to try?
A common medication of a different class is gabapentinoids, which are shown to be beneficial in neuropathy related pain. But this class of drugs has been increasingly prescribed as an off label use for chronic low back pain.
A recent review2 of 8 randomized controlled studies compared gabapent or pregabalin to other analgesics. They found there was no significant benefit for using a gabapentinoid. In addition, the side effects from the use of this medication could include dizziness, fatigue, difficulties with mentation, and visual disturbances.
On the score of cost, efficacy, and side effects, gabapentinoids didn’t do well. More thorough studies were recommended before these drugs continue to be used for chronic low back pain.
What is a person to do that has chronic back pain? Movement and brain retraining. This could proceed in a number of ways, but the side effects are low. Addiction is nonexistent. And at the very least, people will learn about themselves in profound ways that can affect their entire life. In my experience, it can also bring people out of pain and lower the use of risky drugs as a coping tool.
P.S. I have seen some pretty remarkable turn arounds.
Cynthia Allen is an expert helping people overcome pain and challenge. Cynthia is a Feldenkrais Practitioner and Senior Trainer in Movement Intelligence. She is creator of the Better Back program and has helped thousands of people with back pain to regain their lives.
Cynthia has a personal understanding of the challenges clients face with back pain and the process that is needed to come out of chronic pain.
1 The Editorial Board. The Insanity of Taxpayer-Funded Addiction. New York Times, Nov. 10, 2017
2 Harsha Shanthanna , Ian Gilron, Manikandan Rajarathinam, Rizq AlAmri, Sriganesh Kamath, Lehana Thabane, Philip J. Devereaux, Mohit Bhandari. Benefits and safety of gabapentinoids in chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. Published: August 15, 2017