Health Care Resource Utilization and Management of Chronic, Refractory Low Back Pain in the United States

Spears, Charis A; Hodges, Sarah E; Kiyani, Musa; Yang, Zidanyue; Edwards, Ryan; Musick, Alexis; Park, Christine; Parente, Beth; Lee, Hui‐Jie; Lad, Shivanand P.

doi:10.1097/brs.0000000000003572

Cited by 31 publications

(26 citation statements)

References 30 publications

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“…Each year, more than 160 million prescriptions for opioids are written in the USA [4]. A recent health care utilization study, specifically regarding chronic back pain in the USA where 55,945 patients were assessed, concludes that between the years 2009 to 2016, 66% of these patients used prescription medications for pain control and the majority (57%) were consuming opioids [5]. Moreover, the National Center for Health Statistics reports that there is still a consistent increase in drug overdose deaths involving synthetic opioids [6].…”

Section: Introductionmentioning

confidence: 99%

Psychosocial, Functional, and Emotional Correlates of Long-Term Opioid Use in Patients with Chronic Back Pain: A Cross-Sectional Case–Control Study

et al. 2021

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Introduction:The opiate epidemic has severe medical and social consequences. Opioids are commonly prescribed in patients with chronic pain, and are a main contributor to the opiate epidemic. The adverse effects of long-term opioid usage have been studied primarily in dependence/addiction disorders, but not in chronic pain. Here, we examine the added iatrogenic effects, psychology, and brain morphology of long-term opioid use in matched patients with chronic pain with and without opioid use (case-controlled design). Methods: We compared psychosocial, functional, and psychological measures between patients with chronic back pain (CBP) who were managing their pain with or without opioids, thereby controlling for the effect of pain on these outcomes. In addition, we investigated brain morphological differences associated with longterm opioid usage. We recruited 58 patients with CBP, 29 of them on long-term opioids and 29 who did not use opioids, and who were matched in

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Section: Introductionmentioning

confidence: 99%

Psychosocial, Functional, and Emotional Correlates of Long-Term Opioid Use in Patients with Chronic Back Pain: A Cross-Sectional Case–Control Study

et al. 2021

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“… [51] CLBP accounts for financial burden and disability. [ 6 7 8 ] Therefore, effective and safe treatment is especially crucial in overcoming low back pain and disability related to the chronic condition.…”

Section: Discussionmentioning

confidence: 99%

“… [6] In the United States, approximately $100 billion of medical expenses is spent annually for back pain with an additional $50 billion arising from indirect costs due to the lost in productivity and disability benefit payments. [7] CLBP is also associated with impaired quality of life, mobility and daily function as well as social isolation, disability, and depression. [ 8 9 ] It is a major health problem leads to more years living with disability than any other musculoskeletal condition.…”

Section: Introductionmentioning

confidence: 99%

“…[ 8 9 ] It is a major health problem leads to more years living with disability than any other musculoskeletal condition. [7] Although financial burden and disability attributed to chronic low back pain is substantially different between countries, the incremental impact of the worldwide health care system is expected to be significant in the coming decades. [8]…”

Section: Introductionmentioning

confidence: 99%

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TCM nonpharmacological interventions for chronic low-back pain

Wang

et al. 2020

Medicine

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Background: chronic low back pain (CLBP) are common symptoms bothering people in daily life. Traditional Chinese medicine (TCM) nonpharmacological interventions are gaining an increasing popularity for CLBP. Nevertheless, the evidence of efficacy and safety of random controlled trials (RCTs) remains controversial. This study aims to evaluate the efficacy and acceptability of different TCM nonpharmacological therapies by systematic review and network meta-analysis. Methods: According to the strategy, The authors will retrieve a total of 7 electronic databases by September 2020, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chongqing VIP, and Wan-fang databases After a series of screening, 2 researchers will use Aggregate Data Drug Information System and Stata software to analyze the data extracted from the randomized controlled trials of TCM nonpharmacological interventions for CLBP. The primary outcome will be the improvement of Pain intensity and functional status/disability and the secondary outcomes will include lobal improvement, health-related quality of life, satisfaction with treatment, and adverse events. Both classical meta-analysis and network meta-analysis will be implemented to investigate direct and indirect evidences on this topic. The quality of the evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation instrument. Results: This study will provide a reliable evidence for the selection of TCM nonpharmacological therapies in the treatment of CLBP. Conclusion: This study will generate evidence for different TCM nonpharmacological therapies for CLBP and provide a decision-making reference for clinical research. Ethics and dissemination: This study does not require ethical approval. The results will be disseminated through a peer-reviewed publication. OSF registration number: DOI 10.17605/OSF.IO/4H3Y9.

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“…Further, a study by Pergolizzi and colleagues (2008) showed that buprenorphine is the safest to use in immunosuppressed or elderly patients susceptible to viruses similar to COVID-19. Steroids also are used to treat chronic pain, particularly lower back pain, and work to suppress immune reactivity (Spears et al, 2020). As such, governing boards including the Faculty of Pain Medicine in the UK have urged caution when utilizing steroids during the COVID-19 pandemic (Liu, Reidy, Saatee, & Collard, 2017;Medicine, 2020).…”

Section: Chronic Pain Medications and Covid-19mentioning

confidence: 99%

A contextual-behavioral perspective on chronic pain during the COVID-19 pandemic and future times of mandated physical distancing

Rhodes

Martin

Guarna

et al. 2020

Journal of Contextual Behavioral Science

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For people who struggle with chronic pain, the COVID-19 pandemic poses new challenges in treatment accessibility and may heighten pre-existing anxiety related to their health condition. Likewise, many mental health providers are struggling to adapt to a new way of caring for these individuals. The current paper aims to provide evidence of the ways in which COVID-19 is impacting people with pain and to offer a contextual-behavioral perspective on treatment of patients with chronic pain during the current pandemic and any future periods of mandated physical distancing. Past research shows that adolescents and adults with chronic pain struggle with loneliness and social isolation, which emphasizes the importance of remaining connected with these patients while they are remaining at home. Further, many individuals with chronic pain have physical and mental health comorbidities that may increase the risk of COVID-19 infection and/or morbidity and mortality. Specific functional-contextual and biopsychosocial concepts common in multidisciplinary treatment of chronic pain can be usefully incorporated into a telehealth model of ACT treatment for pain. These include the use of pandemicrelated metaphors, modeling acceptance of technical glitches that occur during telehealth sessions, and mindfully observing facial expressions on the computer screen when the patient is in pain. Moreover, powerful experiential exercises that make use of pandemic-related themes (e.g., wearing a mask, washing hands) are described. While barriers to the widespread implementation of ACT-consistent telehealth exist, connecting with patients in new and creative ways will be essential as the field moves forward.

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Health Care Resource Utilization and Management of Chronic, Refractory Low Back Pain in the United States

Cited by 31 publications

References 30 publications

Psychosocial, Functional, and Emotional Correlates of Long-Term Opioid Use in Patients with Chronic Back Pain: A Cross-Sectional Case–Control Study

Psychosocial, Functional, and Emotional Correlates of Long-Term Opioid Use in Patients with Chronic Back Pain: A Cross-Sectional Case–Control Study

TCM nonpharmacological interventions for chronic low-back pain

A contextual-behavioral perspective on chronic pain during the COVID-19 pandemic and future times of mandated physical distancing

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