Opioid pain-relieving medicines are not more effective than a placebo in relieving acute back and neck pain and may even cause harm, according to a recent trial. The researchers say this is proof that treatment guidelines should be updated to advise against the use of opioids for this purpose.

Over 577 million people worldwide experience low back and neck pain at any one time. Despite a global push to reduce the use of opioids, approximately 40 to 70 percent of those who present with neck and back complaints are prescribed opioids for their pain.

What did the study find?

At six weeks, those who received opioids did not have better pain relief than those given the placebo. Quality of life and pain outcomes at long-term follow-up were better in the placebo group. Patients who received opioids were at a small but significantly higher risk of opioid misuse 12 months after their short course of medication.

The research team says that according to current back and neck pain guidelines, opioids can be considered as a last resort if all other pharmacological options have failed, however, this study is evidence that opioids should not be recommended at all.

Co-author Professor Chris Maher said in recent years there has been a shift in focus from opioid to non-opioid treatments for low back pain, with a focus on physical and psychological therapies and simple analgesics such as anti-inflammatory medicines (called NSAIDS).

Chiropractors offer a proven, expert, non-opioid, hands-on “gold standard" of physical medicine for low back pain.

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