Opioids No Better Than Non-Opioids for Back Pain and Arthritis

When it comes to treating the pain of chronic osteoarthritis, non- opioid pain relievers do the job better than opioids, and with fewer side effects, according to a recent study published in the Journal of the American Medical Association. The researchers, from the Minneapolis Veterans Affairs Health Care System, studied 240 patients with moderate-to-severe chronic back pain or knee or hip osteoarthritis. This was the first randomized trial of opioid medication to look into long-term patient pain and function, according to the authors.

Patients were randomized and given either an opioid pain reliever (oxycodone, hydrocodone or morphine) or a non-opioid pain reliever (acetaminophen, topical lidocaine or a non-steroidal anti-inflammatory medication). They then were given an 11-point scale to measure pain and function. Higher scores indicated worse results. 

After 12 months, the patients receiving opioids reported an average of 3.4 on the function scale and the non-opioid group reported 3.3, which the researchers deemed an insignificant difference. On the pain scale, however, the non-opioid patients reported 3.5 and the opioid patients reported 4.0, which was a significant difference. Also, the patients taking opioids reported significantly more medication side effects.

The researchers concluded that treatment with opioids was not superior to treatment with non-opioid medications for improving pain- related function over 12 months. They also noted that the study results do not support initiation of opioid therapy for moderate-to- severe chronic back pain or for hip or knee osteoarthritis pain.

Source: Journal of the American Medical Association