Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2014 Apr;23(4):800-6.
doi: 10.1007/s00586-014-3229-7. Epub 2014 Feb 15.

Do analgesics improve functioning in patients with chronic low back pain? An explorative triple-blinded RCT

Henrica R Schiphorst Preuper  1 , Jan H B Geertzen, Marten van Wijhe, Anne M Boonstra, Barbara H W Molmans, Pieter U Dijkstra, Michiel F Reneman
Affiliations
Randomized Controlled Trial

Do analgesics improve functioning in patients with chronic low back pain? An explorative triple-blinded RCT

Henrica R Schiphorst Preuper et al. Eur Spine J. 2014 Apr.

Abstract

Purpose: TREATMENT of patients with chronic low back pain (CLBP) aims to reduce disability, improve functional capacity, and participation. Time contingent prescription of analgesics is a treatment modality in CLBP. The impact of analgesics on functional capacity is unknown. Aim of the study was to explore the effect of analgesics on functioning measured by functional capacity evaluation, and self-reported disability in patients with CLBP.

Methods: Explorative Randomized Placebo-Controlled Clinical Trial was performed in an outpatient pain rehabilitation setting on patients waiting for rehabilitation. Included patients had low back pain lasting >3 months, visual analogue scale worst pain ≥4.0 cm, and age >18 years. Outcome measures before (T0) and after treatment (T1): functional capacity, pain intensity, Roland Morris Disability Questionnaire. T1: global perceived pain relief. Patient characteristics and psychological questionnaires were assessed. Fifty patients were included in this study and were randomly assigned to 2 weeks treatment or placebo.

Treatment: acetaminophen/tramadol 325 mg/37.5 mg per capsule. Dose: maximum acetaminophen 1,950 mg and tramadol 225 mg per day; treatment and placebo titrated identically. Compliance and side-effects were monitored. TREATMENT effects between groups over time were compared.

Results: One patient (treatment group) was lost to follow-up. Forty-nine patients remained in the study. TREATMENT effects in primary outcomes did not differ significantly between groups. A subgroup of 10 (42%) patients (treatment group) reported global pain relief (responders) who reduced self-reported disability (p < 0.05). Responders had significantly lower catastrophizing scores.

Conclusion: Overall treatment effects were small and non-significant. A subgroup, however, reported improved functioning as a result of treatment. Responders had lower catastrophizing scores.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flowchart
See this image and copyright information in PMC

References

    1. Truchon M. Determinants of chronic disability related to low back pain: towards an integrative biopsychosocial model. Disabil Rehab. 2001;23:758–767. doi: 10.1080/09638280110061744. - DOI - PubMed
    1. Borenstein DG. Epidemiology, etiology, diagnostic evaluation, and treatment of low back pain. Curr Opin Rheumatol. 2001;13:128–134. doi: 10.1097/00002281-200103000-00006. - DOI - PubMed
    1. International classification of functioning, disability and health (ICF) Geneva: World Health Organization; 2001.
    1. Linton SJ. A review of psychological risk factors in back and neck pain. Spine. 2000;25:1148–1156. doi: 10.1097/00007632-200005010-00017. - DOI - PubMed
    1. Schiphorst Preuper HR, Reneman MF, Boonstra AM, Dijkstra PU, Versteegen GJ, Geertzen JHB, Brouwer S. Relationship between psychological factors and performance-based and self-reported disability in chronic low back pain. Eur Spine J. 2009;17:1448–1456. doi: 10.1007/s00586-008-0772-0. - DOI - PMC - PubMed

Publication types

MeSH terms

Associated data