Header

UZH-Logo

Maintenance Infos

Medikamentöse Therapie bei akuten und chronischen lumbalen Rückenschmerzen


Wertli, M M; Steurer, J (2018). Medikamentöse Therapie bei akuten und chronischen lumbalen Rückenschmerzen. Der Internist, 59(11):1214-1223.

Abstract

Low back pain is common. In the acute (duration <6 weeks) and subacute pain phases (6-12 weeks) the main goal of pharmacological pain treatment is to enable patients to move and to stay as active as possible. In the chronic phase, pain medications can support non-pharmacological measures and improve physical function. Although almost every person will experience low back pain at least once in a lifetime, for many pain medications no clinical studies on their efficacy exist. Most data are available on the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) in acute and chronic low back pain; however, potential adverse effects and contraindications for NSAIDs need to be taken into account when the medication is prescribed. For other non-opioid medications (e. g. paracetamol, metamizole) the efficacy is not well studied. Weak and strong opioids have been shown to be effective compared to placebo in the short term; however, there is increasing evidence that opioids are no more effective than non-opioid medications in the treatment of acute and chronic low back pain. Furthermore, gastrointestinal and central nervous system adverse effects of opioids should be considered. Conclusion: in low back pain, the choice of a specific pain medications is based on the individual patient preferences, contraindications, and potential adverse effects. The main goal of pain medications is to enable patients to stay active. In persisting pain, non-pharmacological measures are important and should complement pharmacological pain treatment.

Abstract

Low back pain is common. In the acute (duration <6 weeks) and subacute pain phases (6-12 weeks) the main goal of pharmacological pain treatment is to enable patients to move and to stay as active as possible. In the chronic phase, pain medications can support non-pharmacological measures and improve physical function. Although almost every person will experience low back pain at least once in a lifetime, for many pain medications no clinical studies on their efficacy exist. Most data are available on the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) in acute and chronic low back pain; however, potential adverse effects and contraindications for NSAIDs need to be taken into account when the medication is prescribed. For other non-opioid medications (e. g. paracetamol, metamizole) the efficacy is not well studied. Weak and strong opioids have been shown to be effective compared to placebo in the short term; however, there is increasing evidence that opioids are no more effective than non-opioid medications in the treatment of acute and chronic low back pain. Furthermore, gastrointestinal and central nervous system adverse effects of opioids should be considered. Conclusion: in low back pain, the choice of a specific pain medications is based on the individual patient preferences, contraindications, and potential adverse effects. The main goal of pain medications is to enable patients to stay active. In persisting pain, non-pharmacological measures are important and should complement pharmacological pain treatment.

Statistics

Citations

Dimensions.ai Metrics
2 citations in Web of Science®
2 citations in Scopus®
Google Scholar™

Altmetrics

Additional indexing

Other titles:Pain medications for acute and chronic low back pain
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic and Policlinic for Internal Medicine
Dewey Decimal Classification:610 Medicine & health
Language:German
Date:November 2018
Deposited On:01 Nov 2018 09:50
Last Modified:24 Sep 2019 23:50
Publisher:Springer
ISSN:0020-9554
OA Status:Closed
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1007/s00108-018-0475-5
PubMed ID:30116855

Download

Full text not available from this repository.
View at publisher

Get full-text in a library