Tuesday, 20 Mar 2018

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No Evidence to Support Use of Gabapentinoids in Low Back Pain

Management of chronic low back pain (CLBP) is often complex, requiring multiple modalities and meds to control pain. An analysis of studies shows that Gabapentinoids, including pregabalin and gabapentin, have little to no benefits but significant risk of adverse effects.  (Citation source https://buff.ly/2warMSU)

In a meta-analysis published in PLOS Medicine, researchers from Canada looked at findings from 8 randomized controlled trials that investigated the use of gabapentinoids in adult CLBP patients.

  • 3 studies comparing gabapentin to placebo, gabapentin showed no significant improvement of pain; 
  • 3 studies comparing pregabalin to other analgesics, pregabalin actually fared worse in pain relief. There were commonly reported adverse events included dizziness, fatigue, confusion, and visual disturbances. Functional and emotional outcomes among patients taking gabapentinoids for CLBP showed no significant improvements.

These highly prescribed agents (pregabalin and gabapentin) have little to offer chronic LBP patients as the existing evidence does not support it, but rather points to greater risks with such therapy. 

The author has no conflicts of interest to disclose related to this subject

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