Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial

Review written by Todd Hargrove info

Key Points

  1. Opioids plus guideline-recommended care for acute low back pain and neck pain were no more effective for pain at six weeks than placebo plus guideline-recommended care.
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BACKGROUND & OBJECTIVE

Opioid analgesics are a common treatment for acute low back pain and neck pain, but there is limited evidence on their efficacy. Clinical guidelines recommend opioid analgesics for people with acute low back or neck pain only when other pharmacological treatments are contraindicated or have not worked. Despite these guidelines, as high as two thirds of people in Australia receive an opioid as first-line treatment when presenting for care with low back pain and neck pain. However, opioids for acute low back pain and neck pain is not supported by direct and robust evidence.

This randomized controlled trial examined the efficacy and safety of a short course of an opioid analgesic for acute low back pain and neck pain.

Opioid analgesics are a common treatment for acute low back pain and neck pain, but there is limited evidence on their efficacy.
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Clinicians should advise clients with acute low back and neck pain that opioids should not be used as a treatment.

METHODS

  • The study recruited 347 patients with less than 12 weeks of low back pain and/or neck pain.
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