Wednesday, March 7, 2018

Chronic Pain Management

A new study by the Minneapolis VA found that chronic pain is managed just as well or better with Tylenol and NSAIDs as it is with opioids. According to the Star Tribune story today,

According to the results published Tuesday, veterans in both groups had similar success, on average, in managing pain and maintaining daily activities for the first six months. But after nine months, patients in the opioid group reported no further progress in reducing the intensity of their pain, while patients in the comparison group showed continued improvement.

One possibility is that patients in the opioid group developed tolerance to the drugs, [Dr.] Krebs said. “That happens with opioids and not with other pain medications.”
And these positive results for non-opioid treatments don't even take into consideration opioid side effects or the risk of overdose.

Some important details on the study design:
[The study] assign[ed] 120 military veterans to take opioids for chronic joint pain for one year, and another 120 to manage their pain with alternatives such as acetaminophen and nonsteroidal anti-inflammatory drugs. Participants were free to pursue physical therapy and other nonsurgical options to address their pain.
The article does not say whether the 240 participants were assigned in a double-blind manner, and I gather there is no placebo control, just the two forms of medication. It would be interesting to know how many of each group availed themselves of physical therapy, but that is also not mentioned in the story.


Update: More information on the study can be found in this later post.

1 comment:

Gina said...

There was a recent story -- wish I could remember where it was published but I saw it on Facebook and re-posted it -- about chronic pain and that it is very real. From talking with doctors and nurses in my own experience, I know that medical professionals have really not doubted that so much. The problem comes when people decide to "fake" the chronic pain in order to get drugs, either from doctors or from ERs. One nurse told me a couple years ago when I was waiting in an ER and barely able to breathe that doctors and nurses working in ERs eventually learn how to tell when someone is faking pain. It made me really sad to think that they had to learn that, but then they're as familiar with human nature as anyone else.