JAMA Study: Opioids No Better Than Nonopioids in Improving Pain-Related Function, Intensity for Chronic Back Pain, Hip/Knee OA

APTA’s #ChoosePT opioid awareness campaign makes the case that opioids simply “mask” pain—but a new study in JAMA has concluded that the drugs probably don’t even do that much, at least not any more effectively than nonopioid medications. The research, which focused on individuals with chronic back pain or hip or knee osteoarthritis (OA) pain, led authors to an unequivocal conclusion: there’s no support for opioid therapy for moderate-to-severe cases of those types of pain.

The published findings are based on a study of 240 randomized patients in the Minneapolis, Minnesota, Veterans Affairs (VA) health care system who reported chronic back pain or knee or hip OA pain, defined as daily moderate-to-severe pain for 6 months or more with no relief provided by analgesic use. Participants were divided into 2 groups: 1 that received an opioid regimen, and a second group that received nonopioid drugs.

To more closely resemble real-world treatment, researchers used a “treat-to-target” approach that stepped up the drugs as needed for participants to reach identified goals. The opioid regimen began with immediate-release morphine, hydrocodone/acetaminophen, and oxycodone, but the regimen could advance to sustained-action morphine and oxycodone, and on to transdermal fentanyl. The nonopioid approach began with acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDS), but it could move on to topical analgesics and finally to drugs requiring prior authorization (such as pregabalin and duloxetine), including tramadol. All participants also were permitted to pursue nondrug treatment during the study, but researchers did not evaluate data related to those treatments.

Full story at APTA

Study identifies exercises to help prevent chronic back pain in runners

A new study from The Ohio State University Wexner Medical Center examines what may cause chronic back pain in runners and the exercises to help prevent it.

The study, published in the Journal of Biomechanics, suggests that runners with weak deep core muscles are at higher risk of developing low back pain. And, unfortunately, most people’s deep core muscles aren’t nearly as strong as they should be.

To examine the role of the superficial and deep core muscles, researchers used motion detection technology and force-measuring floor plates to estimate muscle movements during activity.

Full story at news-medical.net