Most cases of back pain resolve in a matter of weeks to months, but for some people the pain becomes a constant problem that interferes with their daily lives. If ignored, chronic back pain - generally defined as unremitting pain that lasts at least six months and is not relieved by standard treatments - can lead to depression, disturbed sleep, poor balance, withdrawal from physical and social activities, inability to work, and a reduced quality of life.

Contrary to what you might expect, taking opioids to ease long-term, chronic pain unrelated to cancer does not in fact relieve pain. Nor does it improve quality of life or every-day functioning.

Opioids are strong narcotics often prescribed for severe pain when other medications don?t work. In a study reported in the journal Pain (Volume 125, page 172), Danish researchers interviewed more than 10,000 adults with chronic pain (but not cancer) that had lasted at least six months, asking how satisfied they were with their treatments. The researchers analyzed responses separately for opiate users and others. They also took into consideration the subjects' age, gender, pain intensity, and use of anxiety and depression medications.

Surprisingly, those who used opioids were much more likely to report moderate to severe or very severe pain, poor health, unemployment, more use of health care services, and a poorer quality of life. While pain can have many causes and may be difficult to pin down, the researchers described their results as “remarkable,” because opioids did not seem to achieve any of the key goals of pain treatment.

Used with permission. For more information, see Johns Hopkins 2008 Back Pain and Osteoporosis White Paper, www.johnshopkinshealthalerts.com/white_papers/back_pain_osteoporosis_wp/digital08_landing.html, by Simeon Margolis, MD, PhD.