Common painkillers best for chronic pain
Doctors and patients have long assumed that opioids are uniquely powerful medicines for chronic pain, despite their risks. But it turns out that this reputation may be a myth.
A government-funded study published this week is among the first long-term studies to compare opioids such as oxycodone and morphine to common painkillers such as acetaminophen in patients with chronic back pain and arthritis, researchers said.
After a year of treatment, opioids weren’t any better at improving pain related to daily functioning, such as ability to sleep and work, the study found. The opioids were also slightly inferior at controlling pain intensity, and patients on them reported many more side effects, according to the results published in the Journal of the American Medical Association.
“The fact that opioids did worse is really pretty astounding,” said Roger Chou, an internist at Oregon Health & Science University and a co-author of Centers for Disease Control and Prevention guide- lines on opioid use for chronic pain, who was not involved in the study.
In the study, lead author Erin Krebs and her colleagues at the Minneapolis Veterans Affairs Health Care System randomly assigned 240 patients with chronic back pain, or hip or knee arthritis, to be treated either with opioid painkillers such as morphine and oxycodone, or nonopioid medicines including standard anti-inflammatory drugs like naproxen, or topical analgesics such as lidocaine.
After a year, about 60 per cent of patients in each group experienced significant improvements in their ability to perform daily functions without pain interfering. But pain intensity improved significantly in just 41 per cent of patients in the opioid group, compared with 54 per cent in the nonopioid group, said Krebs, a primary care doctor at the Minneapolis VA.
The results “will be surprising for a lot of people,” Krebs said.
While opioids provide potent relief for acute pain, that doesn’t necessarily translate to a chronic pain situation.