A randomized controlled testing of both Emergency Room sites and adult patients experiencing one or both of these acute conditions was published in the Lancet on June 28, 2023. The results of the testing show that opioids used for back and/or neck pain overall produce no better results than placebos. In addition, after 1 year, 20% of the patients who received opioids were at risk of misuse compared to only 10 % of the patients in the placebo group.
These results have been the first published validation that opioids are less effective than other palliative treatments such as staying active, avoiding bed rest, using hot or cold packs and taking anti-inflammatory drugs for short term pain relief. Through studies like this and ongoing education, opioids are becoming the non-prevalent treatment guideline for most physicians when treating acute low back and neck pain. In addition, it is much safer to avoid opioid medications all together to avoid a potentially addicting circumstance at a later date.
The results of this test should reassure physicians and other medical stakeholders that prescribing opioid medications, in these situations, is not in the best interest of the patient from a pain management perspective and does not result in better outcomes.
Some current clinical guidelines still recommend using opioids for these conditions, in cases where other drug treatments either fail or are contraindicated. This study seems to validate that use of opioids should not be recommended regardless.
What does this mean for all Workers’ Compensation stakeholders involved in delivering the most appropriate care to injured workers, dedicated to optimum recovery and restoration to their quality of life? Since low back pain is one of the most common injuries in Workers’ Compensation, the opportunity to scrutinize potentially inappropriate use of opioid medications early in the claim treatment phase may result in better pain management, expedient recovery and a reduction in aberrant drug-related behavior.
The use of opioid medications is at an all-time low. However, there is a need to remain vigilant and to insure that those patients in need of pain management are not deprived of treatment, but are encouraged to obtain the an optimum combination of medications and other proven alternative options.