People with back pain are being prescribed a drug which does nothing to help their discomfort.
A study has found a drug commonly prescribed to treat lower back pain is actually ineffective.
The drug pregabalin works no better than a placebo to control pain, doctors discovered.
Pregabalin, which is marketed by pharmaceutical company Pfizer under the name Lyrica, is commonly prescribed all over the world to treat chronic lower back pain syndromes such as lumbar spinal stenosis.
This syndrome, which is the leading reason why elderly people have spinal surgery, causes shooting or twinging pains, tingling, and numbness in the lower back, buttocks, and legs.
These symptoms are often called sciatica.
The pain is caused by a compression of the nerves in the back, which usually happens because the spinal canal – the space the spinal cord goes through – becomes more narrow as vertebrae, discs, muscles and ligaments in the spinal column are worn away with age.
As part of the study, researchers asked people with lumbar spinal stenosis to report on their pain levels while walking on a treadmill.
This is because the pain associated with the condition normally occurs when the person is standing or walking, and it usually feels better by bending forward at the waist.
This is why the elderly are often seen hunched over with a cane or a walker.
Researchers found there was no significant difference in the levels of pain experienced by those taking the drug and those that were given a placebo.
Meanwhile, common side effects include headaches, dizziness and feeling sleepy, but less commonly, blurred or double vision, co-ordination and balance problems and weight gain can occur, amongst many others.
Doctors often prescribe pregabalin, even though it is not technically approved to treat back pain.
This is one of it’s ‘off-label’ uses, a common and practice where doctors prescribe a medicine they think might help, but have not been tested in official clinical trials.
This is because there are few other treatments for lumbar spinal stenosis, which can sometimes be so severe it leaves people unable to walk.
They may also lose their bladder or bowel functions.
In such cases, patients might try strong pain medications and epidural steroid injections, which are given to help with back pain.
Some patients decide to have an operation to remove a part of the bone or disc in the back to give the nerve roots more room and stop the pain.
This procedure – called a lumbar laminectomy – is the most common reason for spine surgery in people over the age of 60.
Lead author Dr John Markman, of the University of Rochester, said: ‘Chronic low back pain is one of the most common reasons why older adults go to the doctor and lumbar stenosis is the leading indication for surgery in this age group.’
Doctors have looked for alternatives to opioids, a group of drugs used to control pain but that are addictive and have many side effects, he said.
So they have increasingly turned to drugs like pregabalin to help patients manage their pain, even though there has been no credible evidence to show they are effective for this problem, he added.
He continued: ‘Given the cost and potential side effects associated with pregabalin, it is critical that we understand the efficacy of this drug.’
‘This study convincingly demonstrates a lack of relief with pregabalin for the walking pain associated with lumbar spinal stenosis.’
The study was published in the journal Neurology.
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