Home >  Health  >  Be wary of narcotics to treat back pain

Be wary of narcotics to treat back pain

Last updated: May 2009

One too many sets of tennis caused lower-back pain for one of our survey respondents, Janie King, 63, of Kula, Hawaii, and prompted her to see her primary-care doctor. He prescribed the opioid (narcotic) pain reliever Vicodin (acetaminophen and hydrocodone). The drug did little to relieve King's pain and caused severe nausea and vomiting.

Prescriptions have doubled

Related Topics

Our low-back-pain survey found that more than 50 percent of those given a prescription drug received an opioid pain reliever, despite the fact that there is very little research to support the use of opioids for acute low-back pain. Opiods may reduce chronic low-back pain when compared to placebo. But clinical trials have shown that about half of the people who take them suffer adverse effects such as drowsiness, respiratory depression, and gastrointestinal symptoms such as constipation, reflux, heartburn, cramping, nausea, and vomiting.

Moreover, other adverse effects of opioids include a paradoxical increase in pain sensitivity, reduced testosterone levels, and erectile dysfunction. Substance-use disorders, such as overuse, getting drugs from more than one doctor, or giving or selling pills to friends, are also reported to affect about 25 percent of people taking opioids for back pain.

Although the side effects often outweigh the benefits, prescriptions of opioids among patients with spinal disorders more than doubled from 1997 to 2004, at least in part because of pharmaceutical-industry marketing and promotion of the drugs. Emergency-department reports of opioid overdose have risen with the numbers of prescriptions.

In my practice, I find that there are almost always better solutions than opioids for low-back-pain patients. As our survey shows, hands-on therapies (available to subscribers) are very successful, and I almost always prescribe them. Exercise can be beneficial. For most people, the best first-line medicines are acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs). Depending on the circumstances, second-line medications, including muscle relaxants, tricyclic antidepressants, and antiseizure drugs, can help. King reports that she improved after six weeks and has been playing tennis since. Although she's had periodic recurrences of pain, she says she has been sure to avoid opioids.

Orly Avitzur, M.D.

Medical Adviser
   

E-mail Newsletters

FREE e-mail Newsletters!
Choose from safety, health, cars, and more!
Already signed-up?
Manage your newsletters here too.

Health News

Is it true that some "extra virgin" olive oil is fake?

Q: I've heard that some olive oil labeled as "extra virgin" really isn't. Is that true? —C.K., Staten Island, N.Y. A. Potentially. In Europe, the "extra virgin" label is strictly regulated ...

Where can I look up drug interactions?

Several drug interaction checkers are available online that can help you determine if your prescription drugs may interact with each other, as well as over-the-counter drugs, vitamins, dietary su...

Weight-loss pill Belviq is now available, but we say skip it

A year after receiving approval by the Food and Drug Administration, you can finally get a prescription for the new weight-loss drug Belviq. But don't. For one, it's only approved for people who ...

Electric razors don't elicit much buzz for Father's Day

Electric razors, along with ties and cologne, seem like a quintessential Father's Day gift. But only 20 percent of those who use a hand razor or an electric shaver said they'd like a new electric...

USDA proposes long-awaited labeling rule for mechanically tenderized beef

Federal regulators have moved a step closer toward requiring mechanically tenderized beef to be labeled so that you are better informed about what you buy and how to cook it safely. The tenderizi...
More news

Connect

Discuss products
and safety with
subscribers and fans

Follow us on:

Mobile

Mobile Get Ratings on the go and compare
while you shop

Learn more