Nonsteroidal anti-inflammatory drugs, such as acetaminophen and ibuprofen, proved better at easing the intensity of chronic back, knee or hip pain than opioids, according to a study published in JAMA.
For the study, a team of researchers recruited patients seeking pain treatment for moderate to severe chronic back pain or hip or knee osteoarthritis pain at Veterans Affairs primary care clinics. After the recruitment phase, the researchers randomly assigned 240 patients to receive opioids or NSAIDs to manage pain for 12 months.
Here are four study findings.
1. Pain intensity for the group of patients receiving an NSAID was significantly better than patients who received an opioid. On a scale from 0 to 10, where 10 indicated worse pain, the opioid group scored their pain intensity at an average of 4.0, in comparison to the NSAID group, who scored their pain intensity at an average of 3.5.
2. Researchers also found opioids are no better than NSAIDs at reducing how much pain interferes with daily activities, such as working, walking or sleeping.
3. Adverse medication-related symptoms were more common in patients who were taking opioids. This was measured with a patient reported checklist. Patients recorded between 0 to 19 medication-related symptoms. The opioid group reported an average of 1.8 medication-related symptoms, in comparison to the NSAID group, who reported an average of 0.9 symptoms.
4. "Treatment with opioids was not superior to treatment with nonopioid medications for improving pain-related function over 12 months. Results do not support initiation of opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain," the study authors concluded.