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Publication Date

3-22-2024

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Presentation: 4:20

Poster attached as supplemental file below

Abstract

Background: Since the 1990s, when the opioid crisis began, over 10 million Americans have reportedly misused prescription opioids and this has led to an average of over 40 deaths per day in the US. Yet, opioid therapy is standard to treat low back pain. Low back pain is a highly prevalent morbidity among US adults, causing great economic burdens through reduction in ability to work and quality of life

Objective: This rapid systematic reviewexamined the efficacy of alternative techniques for prescribing opioids to treat low back pain that are not addictive. These techniques include physical therapy, epidural steroid injections, and non-steroidal anti-inflammatory drugs (NSAIDs).

Design/Methods: A rapid literature review was performed using Pubmed and Scopus, with a search strategy developed in collaboration with a librarian. The articles were screened using the eligibility criteria, which led to a final selection of nine studies. The data looked at the interventions compared to opioids and how that affected self-reported pain levels.

Results: All selected studies that compared physical therapy or epidural steroid injections to opioids found they were more effective at decreasing pain levels. Selected studies that compared the effectiveness of NSAIDs to opioids had mixed results.

Conclusion: These key findings inform the need for healthcare professionals to consider opioid alternatives to treat low back pain, and as tools to reduce consumption in those currently using opioids. Further research can strengthen insurance and prescription guidelines that will maximize the use of non-opioid interventions.

Lay Summary

Prescription opioid overdoses continue to increase in the United States. The opioid crisis began in the 1990s when a powerful drug called Oxycontin was promoted by Purdue Pharma and approved by the Food and Drug Administration. Healthcare providers were told by pharmaceutical companies that opioid pain relievers were not addictive, even though research has later proven this to be false. Over twenty years later, there are 10 million people misusing prescription drugs each year and forty-five people overdosing every day from a drug prescribed by their doctor. One condition that leads to the opioid crisis is low back pain, as opioid therapy is standard to treat it. Most adults in the United States will experience low back pain at some point in their lives, which is why it is important to focus on pain management techniques that do not involve opioids and their addictive nature. The fact that opioid therapy is common for low back pain is a problem. Healthcare professionals should consider giving patients experiencing low back pain non-addictive options for pain management that are still proven to be effective. A rapid literature review of alternative techniques that include physical therapy, epidural steroid injections, and non-steroidal anti-inflammatory drugs was completed to see if they were more effective at decreasing pain compared to opioids. A PICO search chart was made with help from a librarian. The search strategy was put into two databases, PubMed and Scopus, to be screened for the relevant criteria. Nine articles were left for analysis. All studies that compared physical therapy or epidural steroid injections to opioids found they were more effective at decreasing pain levels. Selected studies that compared the effectiveness of NSAIDs to opioids had mixed results. A majority of the articles showed that using opioids was reduced following the interventions. These findings show the need for healthcare professionals to consider opioid alternatives to treat lower back pain. In addition, these alternatives can also be used as tools to reduce consumption in those who are already using opioids. Barriers to using non-opioid interventions as a first line of treatment still need to be understood and addressed. More research in the future can create stronger insurance and prescription guidelines that will maximize the use of non-opioid interventions.

Additional Files
2024_Volz_Karlie_poster.pptx (812 kB)

Language

English

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