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Physical Functioning and Opioid use in Patients with Neuropathic Pain
Geoff P Bostick1, Cory Toth2, Eloise C J Carr3
1Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
Pain Medicine (Malden, Mass.)
|February 4, 2015
Summary
Opioid therapy did not improve physical function or disability in neuropathic pain (NeP) patients compared to those not on opioids. Modest improvements were seen across all groups, but they may not be clinically significant.
Area of Science:
- Pain Medicine
- Neurology
- Clinical Research
Background:
- Neuropathic pain (NeP) management remains challenging.
- Opioid therapy is frequently used, but its impact on physical function and disability in NeP is not fully understood.
- Understanding the relationship between opioid dosage and patient outcomes is crucial for optimizing treatment strategies.
Purpose of the Study:
- To evaluate the association between opioid dosage and ongoing therapy with physical function and disability in patients with neuropathic pain (NeP).
Main Methods:
- Secondary analysis of a prospective, multicenter clinical NeP registry.
- Included 789 patients with various NeP diagnoses.
- Assessed physical function and disability using validated scales, comparing opioid doses (none, ≤200 mg, >200 mg morphine equivalent) and ongoing use, adjusting for confounders like age, sex, pain intensity, and psychological distress.
Main Results:
- Complete data was available for 535 patients.
- NeP patients not taking opioids demonstrated statistically lower disability and higher physical functioning scores compared to those on lower or higher opioid doses, after adjusting for disease severity.
- Ongoing opioid use was associated with statistically higher disability and lower physical functioning scores compared to non-use, after adjusting for disease severity.
- Improvements in disability and physical functioning scores from baseline to 12 months were modest and potentially not clinically significant across all groups.
Conclusions:
- Physical functioning and disability did not improve in NeP patients prescribed opioids compared to those not prescribed opioids, even after adjusting for disease severity.
- The findings suggest that opioid therapy may not be associated with improved physical function or reduced disability in patients with neuropathic pain.
- Further research is warranted to explore alternative pain management strategies for NeP that prioritize functional improvement and disability reduction.
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