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Significant Efficacy of Tramadol/Acetaminophen in Elderly Patients with Chronic Low Back Pain Uncontrolled by NSAIDs: An Observational Study.

Imamura T - Open Orthop J (2015)

Bottom Line: The mean RDQ (p = 0.015) and ODI (p = 0.0032) scores were improved at 1 month.A total 41.6% of patients reported nausea and floating sensation beginning tramadol/acetaminophen treatment, and 12.5% (four patients) discontinued treatment as a result.LBP did not improve in 25% of patients administered tramadol/acetaminophen.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Japan Labour Health and Welfare Organization, Kyushu Rosai Hospital, 1-1 Sonekitamachi, Kitakyushu, Fukuoka, 800-0296, Japan.

ABSTRACT
Chronic low back pain (LBP) is a common condition and is generally treated using non-steroidal anti-inflammatory drug (NSAID); however, chronic NSAID use can decrease renal function. Tramadol, a weak opioid agonist, may improve chronic LBP and disability, while avoiding adverse effects such as gastrointestinal and renal toxicity. However, few studies have evaluated the short-term efficacy of opioids in Asian patients with chronic LBP. In this study, 24 patients with chronic LBP unresponsive to NSAIDs (10 men, 14 women; mean age, 65.1 ± 12.1 years) were prescribed tramadol/acetaminophen (37.5 mg/325 mg; four tablets daily) for 1 month. Then, the following parameters were assessed at baseline and after 1 week and 1 month of treatment: leg pain and LBP (Visual Analog Score [VAS]); activity of daily life (Roland-Morris Disability Questionnaire [RDQ]); and disability (Oswestry Disability Index [ODI]). Leg pain resolved within 1 week (p = 0.00093); however, LBP was relieved only at 1 month (p = 0.00034). The mean RDQ (p = 0.015) and ODI (p = 0.0032) scores were improved at 1 month. A total 41.6% of patients reported nausea and floating sensation beginning tramadol/acetaminophen treatment, and 12.5% (four patients) discontinued treatment as a result. LBP did not improve in 25% of patients administered tramadol/acetaminophen. Because this was an observational study, rather than a comparative study, further investigation is needed to evaluate the long-term efficacy of tramadol/acetaminophen in elderly patients with chronic LBP unresponsive to NSAIDs.

No MeSH data available.


Related in: MedlinePlus

Mean (± SD) Visual Analog Score (VAS) for low back pain and leg pain after administering tramadol/acetaminophen. Leg painsignificantly improved after 1 week of treatment (p = 0.00093); however, LBP only improved after 1 month of treatment (p = 0.00034). SD,standard deviation; LBP, low back pain.
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Figure 1: Mean (± SD) Visual Analog Score (VAS) for low back pain and leg pain after administering tramadol/acetaminophen. Leg painsignificantly improved after 1 week of treatment (p = 0.00093); however, LBP only improved after 1 month of treatment (p = 0.00034). SD,standard deviation; LBP, low back pain.

Mentions: To evaluate magnitude of pain relief provided by tramadol/acetaminophen, we measured the VAS for LBP and leg pain (Fig. 1). At 1 week after beginning tramadol/acetaminophen treatment, the VAS for leg pain was significantly reduced (p = 0.00093). LBP was not improved at 1 week, but showed significant improvement at 1 month after initiating treatment (p = 0.00034). As shown in Fig. (2), the mean RDQ before beginning tramadol/acetaminophen treatment was 10.9, and 1 month later, the RDQ significantly improved to 7.3 (1 week, p = 0.511; 1 month, p = 0.00034). The mean ODI initially was 46.7. At 1 week, there was no significant improvement in the ODI score (p = 0.509). One month after beginning treatment, the mean ODI improved to 36.5 (p = 0.00316; Fig. 3).


Significant Efficacy of Tramadol/Acetaminophen in Elderly Patients with Chronic Low Back Pain Uncontrolled by NSAIDs: An Observational Study.

Imamura T - Open Orthop J (2015)

Mean (± SD) Visual Analog Score (VAS) for low back pain and leg pain after administering tramadol/acetaminophen. Leg painsignificantly improved after 1 week of treatment (p = 0.00093); however, LBP only improved after 1 month of treatment (p = 0.00034). SD,standard deviation; LBP, low back pain.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4484344&req=5

Figure 1: Mean (± SD) Visual Analog Score (VAS) for low back pain and leg pain after administering tramadol/acetaminophen. Leg painsignificantly improved after 1 week of treatment (p = 0.00093); however, LBP only improved after 1 month of treatment (p = 0.00034). SD,standard deviation; LBP, low back pain.
Mentions: To evaluate magnitude of pain relief provided by tramadol/acetaminophen, we measured the VAS for LBP and leg pain (Fig. 1). At 1 week after beginning tramadol/acetaminophen treatment, the VAS for leg pain was significantly reduced (p = 0.00093). LBP was not improved at 1 week, but showed significant improvement at 1 month after initiating treatment (p = 0.00034). As shown in Fig. (2), the mean RDQ before beginning tramadol/acetaminophen treatment was 10.9, and 1 month later, the RDQ significantly improved to 7.3 (1 week, p = 0.511; 1 month, p = 0.00034). The mean ODI initially was 46.7. At 1 week, there was no significant improvement in the ODI score (p = 0.509). One month after beginning treatment, the mean ODI improved to 36.5 (p = 0.00316; Fig. 3).

Bottom Line: The mean RDQ (p = 0.015) and ODI (p = 0.0032) scores were improved at 1 month.A total 41.6% of patients reported nausea and floating sensation beginning tramadol/acetaminophen treatment, and 12.5% (four patients) discontinued treatment as a result.LBP did not improve in 25% of patients administered tramadol/acetaminophen.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Japan Labour Health and Welfare Organization, Kyushu Rosai Hospital, 1-1 Sonekitamachi, Kitakyushu, Fukuoka, 800-0296, Japan.

ABSTRACT
Chronic low back pain (LBP) is a common condition and is generally treated using non-steroidal anti-inflammatory drug (NSAID); however, chronic NSAID use can decrease renal function. Tramadol, a weak opioid agonist, may improve chronic LBP and disability, while avoiding adverse effects such as gastrointestinal and renal toxicity. However, few studies have evaluated the short-term efficacy of opioids in Asian patients with chronic LBP. In this study, 24 patients with chronic LBP unresponsive to NSAIDs (10 men, 14 women; mean age, 65.1 ± 12.1 years) were prescribed tramadol/acetaminophen (37.5 mg/325 mg; four tablets daily) for 1 month. Then, the following parameters were assessed at baseline and after 1 week and 1 month of treatment: leg pain and LBP (Visual Analog Score [VAS]); activity of daily life (Roland-Morris Disability Questionnaire [RDQ]); and disability (Oswestry Disability Index [ODI]). Leg pain resolved within 1 week (p = 0.00093); however, LBP was relieved only at 1 month (p = 0.00034). The mean RDQ (p = 0.015) and ODI (p = 0.0032) scores were improved at 1 month. A total 41.6% of patients reported nausea and floating sensation beginning tramadol/acetaminophen treatment, and 12.5% (four patients) discontinued treatment as a result. LBP did not improve in 25% of patients administered tramadol/acetaminophen. Because this was an observational study, rather than a comparative study, further investigation is needed to evaluate the long-term efficacy of tramadol/acetaminophen in elderly patients with chronic LBP unresponsive to NSAIDs.

No MeSH data available.


Related in: MedlinePlus