Effects of Opioids and Nonsteroidal Anti-Inflammatory Drugs on Chronic Low Back Pain and Related Measures: Results from the PRECISION Pain Research Registry.

Measuring treatments used by 202 patients with chronic low back pain in the PRECISION Pain Research Registry, this study determined the associations of opioid and nonsteroidal anti-inflammatory drug (NSAID) therapy with clinical status. More than one-fourth of patients did not use nonpharmacologic treatments for low back pain. Patients age 50-59 and 60-79 years old were more likely to use opioids than younger patients. Patients using opioids reported greater pain and back-related disability than did patients using NSAIDs. Patients concurrently using opioids and NSAIDs reported greater back-related disability and poorer quality of life than did patients using no or other pharmacologic therapy. No significant associations between pharmacologic therapy and clinical status remained after controlling for potential confounders. Neither opioids nor opioids combined with NSAIDs were more effective than just NSAIDs. Greater use of nonpharmacologic therapies and better second-line, nonopioid pharmacologic therapies appear necessary for more effective treatment of chronic low back pain.