People with LBP who are on long term opioid therapy (longer than 6 weeks) are considered for referral for assessment by a pain specialist.
Deyo, R.A., Von Korff, M. and Duhrkoop, D., 2015. Opioids for low back pain. BMJ, 350, p.g6380.
Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists 2015. Recommendations regarding the use of Opioid Analgesics
in patients with chronic Non-Cancer Pain. Available at: http://fpm.anzca.edu.au/documents/pm1-2010
Frieden TR, Jaffe HW, Cono J et al 2016. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep 2016;65(1): 1-50.
Errata: Vol. 65, No. RR-1. MMWR Morb Mortal Wkly Rep 2016;65:295. DOI: http://dx.doi.org/10.15585/mmwr.mm6511a6
NHMRC Australian Acute Musculoskeletal Pain Guidelines Group 2003. Evidence-based Management of Acute Musculoskeletal Pain. Available at: https://www.nhmrc.gov.au/
There are no randomised controlled trials investigating the efficacy of opioids and compound analgesics in acute low back pain.
No Level I or II Evidence
In general, opioids and compound analgesics have a substantially increased risk of side effects compared with paracetamol alone.