Substantive review of the literature of medication treatment of chronic low back pain among adults

Abstract

Purpose Pain can be debilitating, and it is often inadequately treated, particularly among patients with chronic low back pain (CLBP). CLBP has a substantial economic impact, as it affects an individual's ability to perform activities of daily living and maintain employment. This study aims to review original studies related to the evidence‐based management of patients with CLBP to develop an algorithm for prescribing medications and recommending other treatment modalities for patients with CLBP. Data sources An electronic search of PubMed, CINAHL, and the Cochrane Database was conducted to identify studies related to the evidence‐based management of CLBP that were performed between 2003 and 2012. The following keywords were used: low back pain, back pain, chronic back pain, medication management, and adjunct therapy. The selected articles were specific to CLBP, medication‐based management, and additional treatment options, such as adjunct therapies. Conclusions The collected data revealed that there are a number of approaches to the management of CLBP. Medication regimens are frequently used and widely available, but alternative treatment modalities can also be effective. Implications for practice Providers should encourage patients to explore a variety of treatment modalities that can provide pain relief and improve functionality and overall well‐being.

Evaluating Different Measures of Low Back Pain Among U.S. Manual Materials Handling Workers: Comparisons of Demographic, Psychosocial, and Job Physical Exposure

“…During follow-up, over 70% of LBP cases reported using medication for LBP, which is comparable with previous observations among industrial workers and patients with LBP (58% to 80%; Cherkin et al, 1998;Ivanova et al, 2011;Kapellusch et al, 2014) but considerably higher than that observed in a gen-( 35%; Vasseljen et al, 2013). This study also found that NSAIDs and OTC pain relievers were the most frequently used types of medications ( 90%) to treat LBP in accordance with prior studies of industrial workers (Kapellusch et al, 2014) and general population (Vasseljen et al, 2013 world practice pattern of the clinical guidelines for LBP management, regardless of an individual's occupation (Bannwarth et al, 2012;Chou et al, 2007;Falope & Appel, 2015;Hart et al, 1995;Holcomb, 2008).…”

“…This study also found that NSAIDs and OTC pain relievers were the most frequently used types of medications (≃90%) to treat LBP in accordance with prior studies of industrial workers (Kapellusch et al, 2014) and general population (Vasseljen et al, 2013). These findings may reflect the real-world practice pattern of the clinical guidelines for LBP management, regardless of an individual’s occupation (Bannwarth et al, 2012; Chou et al, 2007; Falope & Appel, 2015; Hart et al, 1995; Holcomb, 2008).…”

“…However, what appears to suggest an increase in LBP severity might simply be conflated with treatments in accordance with the LBP management strategy developed by medical professionals or a circumstance of company policies or culture. For example, the American College of Physicians (ACP) and the American Pain Society (APS) recommend the use of medication, such as over-the-counter (OTC) pain reliever (e.g., acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs), as a first-line intervention to improve or resolve nonspecific LBP (Bannwarth et al, 2012; Chou et al, 2007; Falope & Appel, 2015; Hart et al, 1995); and approximately 70% of patients in primary care reported medication use for LBP as recommended by their physicians in the United States (Cherkin et al, 1998; Ivanova et al, 2011). However, most prior comparisons of LBP measures have been conducted in clinical settings (Norton et al, 2016; Taylor-Stokes et al, 2011; Wilkie et al, 2015) and using cross-sectional study designs (Ferguson et al, 2019; Ozguler et al, 2000).…”

Therapeutic Potential of Downregulated Interleukin-6 Signaling for the Treatment of Chronic Pain: A Mendelian Randomization Study

“…8 A wide range of pharmacological options, such as opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and gabapentin, among others, are currently available for the management of chronic pain. [9][10][11] Nevertheless, current treatments remain somewhat limited with over 50% of patients experiencing an inadequate relief of pain that requires the emergence of fresh therapeutic alternatives. 12 In the classical cis-signaling pathway, the initiation of the inflammatory response by Interleukin-6 (IL-6) occurs through its binding with glycoprotein-130 (gp130) at the IL-6 receptor locus present on the cell membrane (m-IL-6R).…”