To Your Health September, 2023 (Vol. 17, Issue 09)

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Make the Right Choice

By Editorial Staff

An important paper¹ appeared recently in The Lancet, one of the oldest, most-respected research journals in the world. The paper reviews the findings of the OPAL (OPioids for acute SpinAL pain) trial.² The study authors looked at the impact of opioids for patients with acute (12 weeks or less) back and/or neck pain.

Patients were divided into two groups, one of which received opioids and the other a placebo [an inactive pill]. Patients were unaware whether they were receiving the opioid or the placebo. Both groups also received "guideline-recommended care," which included things like positive reassurance, advising patients to stay active and avoid bed rest, and "other guideline-recommended treatments."

The primary objective of the study: to determine any differences in pain severity between the two groups. Secondary objectives included potential improvements in disability, recovery time, quality of life, and cost-effectiveness.

Results demonstrated that opioids were no more effective at reducing back and neck pain than placebo. In addition, "more people in the opioid group reported opioid-related adverse events." The study authors noted: "Opioids should not be recommended for acute non-specific low back pain or neck pain given that we found no significant difference in pain severity compared with placebo." [Emphasis added]

These results are significant in that the OPAL study is the first randomized, placebo-controlled trial to investigate the efficacy of opioids for acute low back and neck pain. Based on their findings, the authors call for "a change in the frequent use of opioids for these conditions."

Other previously published research papers, as well as thousands upon thousands of satisfied patients, support the effectiveness of chiropractic for both back and neck pain. When combined with the results of the OPAL study, the message is clear: Chiropractic can get results where opioids can't.

References

1. Jones C, Day RO, Koes BW, et al. Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial. Lancet, June 28, 2023 (published online ahead of print).
2. Jones C, Lin CWC, Day RO, et al. OPAL: a randomised, placebo-controlled trial of opioid analgesia for the reduction of pain severity in people with acute spinal pain - a statistical analysis plan. Trials, 2022;23:212.