Do strong opioids have a role in the early management of back pain? Recommendations from a European expert panel

E. Kalso, L. Allan, J. Dobrogowski, M. Johnson, N. Krcevski-Skvarc, Gary John MacFarlane, G. Mick, S. Ortolani, S. Perrot, A. Perucho, I. Semmons, J. Sorensen

Research output: Contribution to journalEditorial

25 Citations (Scopus)

Abstract

Background: Since chronic low back pain (CLBP) is a complex biopsychosocial problem the ideal treatment is multimodal and multidisciplinary. However, in many countries, primary-care physicians care for many people with CLBP and have a pivotal role in selecting patients for more intensive treatments when these are available. Guidelines on the general use of strong opioids in chronic non-cancer pain have been published but, until now, no specific guidelines were available on their use in chronic low back pain. Given the prevalence of CLBP, and the complex nature of this multifactorial condition, it was felt that specific, evidence-based recommendations, with a focus on primary-care treatment, would be helpful.

Methods: An expert panel drawn from across Europe including pain specialists, anaesthetists, neurologists, rheumatologists, a general practitioner, an epidemiologist and the chairman of a pain charity was therefore convened. The aim of the group was to develop evidence-based recommendations that could be used as a framework for more specific guidelines to reflect local differences in the availability of specialist pain services and in the legal status and availability of strong opioids. Statements were based on published evidence (identified by a literature search) wherever possible, and supported by clinical experience when suitable evidence was lacking.

Recommendations: Strong opioids have a role in the treatment of low back pain when other treatments have failed. They should be prescribed as part of a multimodal, and ideally interdisciplinary, treatment plan. The aim of treatment should be to relieve pain and facilitate rehabilitation.

Original languageEnglish
Pages (from-to)1819-1828
Number of pages9
JournalCurrent Medical Research and Opinion
Volume21
Issue number11
DOIs
Publication statusPublished - 2005

Keywords

  • analgesia
  • back pain
  • chronic pain
  • opioids
  • CHRONIC NONCANCER PAIN
  • CHRONIC NONMALIGNANT PAIN
  • NONSTEROIDAL ANTIINFLAMMATORY DRUGS
  • IMMEDIATE-RELEASE OXYCODONE
  • QUALITY-OF-LIFE
  • DOUBLE-BLIND
  • TRANSDERMAL FENTANYL
  • NEUROPATHIC PAIN
  • OUTCOME MEASURES
  • DRIVING ABILITY

Cite this

Do strong opioids have a role in the early management of back pain? Recommendations from a European expert panel. / Kalso, E.; Allan, L.; Dobrogowski, J.; Johnson, M.; Krcevski-Skvarc, N.; MacFarlane, Gary John; Mick, G.; Ortolani, S.; Perrot, S.; Perucho, A.; Semmons, I.; Sorensen, J.

In: Current Medical Research and Opinion, Vol. 21, No. 11, 2005, p. 1819-1828.

Research output: Contribution to journalEditorial

Kalso, E, Allan, L, Dobrogowski, J, Johnson, M, Krcevski-Skvarc, N, MacFarlane, GJ, Mick, G, Ortolani, S, Perrot, S, Perucho, A, Semmons, I & Sorensen, J 2005, 'Do strong opioids have a role in the early management of back pain? Recommendations from a European expert panel', Current Medical Research and Opinion, vol. 21, no. 11, pp. 1819-1828. https://doi.org/10.1185/030079905X65303
Kalso, E. ; Allan, L. ; Dobrogowski, J. ; Johnson, M. ; Krcevski-Skvarc, N. ; MacFarlane, Gary John ; Mick, G. ; Ortolani, S. ; Perrot, S. ; Perucho, A. ; Semmons, I. ; Sorensen, J. / Do strong opioids have a role in the early management of back pain? Recommendations from a European expert panel. In: Current Medical Research and Opinion. 2005 ; Vol. 21, No. 11. pp. 1819-1828.
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abstract = "Background: Since chronic low back pain (CLBP) is a complex biopsychosocial problem the ideal treatment is multimodal and multidisciplinary. However, in many countries, primary-care physicians care for many people with CLBP and have a pivotal role in selecting patients for more intensive treatments when these are available. Guidelines on the general use of strong opioids in chronic non-cancer pain have been published but, until now, no specific guidelines were available on their use in chronic low back pain. Given the prevalence of CLBP, and the complex nature of this multifactorial condition, it was felt that specific, evidence-based recommendations, with a focus on primary-care treatment, would be helpful.Methods: An expert panel drawn from across Europe including pain specialists, anaesthetists, neurologists, rheumatologists, a general practitioner, an epidemiologist and the chairman of a pain charity was therefore convened. The aim of the group was to develop evidence-based recommendations that could be used as a framework for more specific guidelines to reflect local differences in the availability of specialist pain services and in the legal status and availability of strong opioids. Statements were based on published evidence (identified by a literature search) wherever possible, and supported by clinical experience when suitable evidence was lacking.Recommendations: Strong opioids have a role in the treatment of low back pain when other treatments have failed. They should be prescribed as part of a multimodal, and ideally interdisciplinary, treatment plan. The aim of treatment should be to relieve pain and facilitate rehabilitation.",
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TY - JOUR

T1 - Do strong opioids have a role in the early management of back pain? Recommendations from a European expert panel

AU - Kalso, E.

AU - Allan, L.

AU - Dobrogowski, J.

AU - Johnson, M.

AU - Krcevski-Skvarc, N.

AU - MacFarlane, Gary John

AU - Mick, G.

AU - Ortolani, S.

AU - Perrot, S.

AU - Perucho, A.

AU - Semmons, I.

AU - Sorensen, J.

PY - 2005

Y1 - 2005

N2 - Background: Since chronic low back pain (CLBP) is a complex biopsychosocial problem the ideal treatment is multimodal and multidisciplinary. However, in many countries, primary-care physicians care for many people with CLBP and have a pivotal role in selecting patients for more intensive treatments when these are available. Guidelines on the general use of strong opioids in chronic non-cancer pain have been published but, until now, no specific guidelines were available on their use in chronic low back pain. Given the prevalence of CLBP, and the complex nature of this multifactorial condition, it was felt that specific, evidence-based recommendations, with a focus on primary-care treatment, would be helpful.Methods: An expert panel drawn from across Europe including pain specialists, anaesthetists, neurologists, rheumatologists, a general practitioner, an epidemiologist and the chairman of a pain charity was therefore convened. The aim of the group was to develop evidence-based recommendations that could be used as a framework for more specific guidelines to reflect local differences in the availability of specialist pain services and in the legal status and availability of strong opioids. Statements were based on published evidence (identified by a literature search) wherever possible, and supported by clinical experience when suitable evidence was lacking.Recommendations: Strong opioids have a role in the treatment of low back pain when other treatments have failed. They should be prescribed as part of a multimodal, and ideally interdisciplinary, treatment plan. The aim of treatment should be to relieve pain and facilitate rehabilitation.

AB - Background: Since chronic low back pain (CLBP) is a complex biopsychosocial problem the ideal treatment is multimodal and multidisciplinary. However, in many countries, primary-care physicians care for many people with CLBP and have a pivotal role in selecting patients for more intensive treatments when these are available. Guidelines on the general use of strong opioids in chronic non-cancer pain have been published but, until now, no specific guidelines were available on their use in chronic low back pain. Given the prevalence of CLBP, and the complex nature of this multifactorial condition, it was felt that specific, evidence-based recommendations, with a focus on primary-care treatment, would be helpful.Methods: An expert panel drawn from across Europe including pain specialists, anaesthetists, neurologists, rheumatologists, a general practitioner, an epidemiologist and the chairman of a pain charity was therefore convened. The aim of the group was to develop evidence-based recommendations that could be used as a framework for more specific guidelines to reflect local differences in the availability of specialist pain services and in the legal status and availability of strong opioids. Statements were based on published evidence (identified by a literature search) wherever possible, and supported by clinical experience when suitable evidence was lacking.Recommendations: Strong opioids have a role in the treatment of low back pain when other treatments have failed. They should be prescribed as part of a multimodal, and ideally interdisciplinary, treatment plan. The aim of treatment should be to relieve pain and facilitate rehabilitation.

KW - analgesia

KW - back pain

KW - chronic pain

KW - opioids

KW - CHRONIC NONCANCER PAIN

KW - CHRONIC NONMALIGNANT PAIN

KW - NONSTEROIDAL ANTIINFLAMMATORY DRUGS

KW - IMMEDIATE-RELEASE OXYCODONE

KW - QUALITY-OF-LIFE

KW - DOUBLE-BLIND

KW - TRANSDERMAL FENTANYL

KW - NEUROPATHIC PAIN

KW - OUTCOME MEASURES

KW - DRIVING ABILITY

U2 - 10.1185/030079905X65303

DO - 10.1185/030079905X65303

M3 - Editorial

VL - 21

SP - 1819

EP - 1828

JO - Current Medical Research and Opinion

JF - Current Medical Research and Opinion

SN - 0300-7995

IS - 11

ER -