HealthDay News – Taking prescription opioids doesn’t improve movement or reduce disability for patients with neuropathic pain, according to a study published recently in Pain Medicine.1

Geoff Bostick, PhD, an associate professor of physical therapy at the University of Alberta in Edmonton, Canada, and colleagues evaluated data for 789 patients with neuropathic pain (NeP). Some were prescribed opioids while others didn’t receive the drugs.

At six- and 12-month follow-ups, patients who took the opioids didn’t show greater improvements in movement and disability than those who did not take the drugs, the investigators found.


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“Pain is very complex, and people experience pain at very different levels,” Bostick said in a university new release. “Opioids can help people with severe pain be more comfortable, but if they are not also facilitating improved function, the impact of these medications on quality of life should be questioned.”

Two authors disclosed financial ties to Pfizer, which contributed funding to the study.


Summary and Clinical Applicability

Initial management of the patient with neuropathic pain involves establishing a diagnosis and pursuing treatment targeted to the specific diagnosis.When pharmacologic management of neuropathic pain is required, the choice of agent should be guided by individual patient factors including the pathophysiology of the pain syndrome, comorbidities,pharmacokinetics/pharmacodynamics, and the risk of adverse effects.

In this article, opiods did not improve physical functioning or disability in patients with neuropathic pain. Certain medications may be indicated for the treatment of specific causes of neuropathic pain. Though the decision to treat pain with a certain medication is made on a case by case basis, there is consensus among the guidelines that first-line agents to treat neuropathic pain include either calcium channel alpha 2-delta ligands (gabapentin, orpregabalin) or tricyclic antidepressants (TCAs).2

Reference 

1. Bostick GP, Toth C, Carr EC, et al. Physical Functioning and Opioid use in Patients with Neuropathic Pain.  Pain Med. 2015 Jul;16(7):1361-8. doi: 10.1111/pme.12702. Epub 2015 Feb 3.

2. O’Connor AB, Dworkin RH. Treatment of neuropathic pain: an overview of recent guidelines. Am J Med 2009; 122:S22.