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Opioids compared to placebo or other treatments for chronic low-back pain

  1. Luis Enrique Chaparro1,*,
  2. Andrea D Furlan2,
  3. Amol Deshpande3,
  4. Angela Mailis-Gagnon4,
  5. Steven Atlas5,
  6. Dennis C Turk6

Editorial Group: Cochrane Back and Neck Group

Published Online: 27 AUG 2013

Assessed as up-to-date: 1 APR 2013

DOI: 10.1002/14651858.CD004959.pub4


How to Cite

Chaparro LE, Furlan AD, Deshpande A, Mailis-Gagnon A, Atlas S, Turk DC. Opioids compared to placebo or other treatments for chronic low-back pain. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD004959. DOI: 10.1002/14651858.CD004959.pub4.

Author Information

  1. 1

    Hospital Pablo Tobon Uribe, Anesthesiology Department, Medellin, Colombia

  2. 2

    Institute for Work & Health, Toronto, ON, Canada

  3. 3

    University Health Network, TWH-Comprehensive Pain Unit, Toronto, ON, Canada

  4. 4

    Toronto Western Hospital Comprehensive Pain Program, Department of Medicine, Toronto, Ontario, Canada

  5. 5

    Massachusetts General Hospital, Medical Practices Evaluation Center, Boston, MA, USA

  6. 6

    University of Washington, Department of Anesthesiology and Pain Medicine, Seattle, Washington, USA

*Luis Enrique Chaparro, Anesthesiology Department, Hospital Pablo Tobon Uribe, Medellin, Colombia. luisdr74@yahoo.com.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 27 AUG 2013

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[Figure 1]
Figure 1. Study flow diagram.
[Figure 2]
Figure 2. Summary of risk of bias of included studies.
[Figure 3]
Figure 3. Funnel plot of comparison: 1 Tramadol compared to placebo, outcome: 1.1 Pain intensity (higher score means worse pain levels).
[Figure 4]
Figure 4. Funnel plot of comparison: 1 Tramadol compared to placebo, outcome: 1.2 Disability (higher ratings mean greater disability).
[Figure 5]
Figure 5. Funnel plot of comparison: 3 Strong opioids compared to placebo, outcome: 1.3 Mean pain intensity.
[Figure 6]
Figure 6. Funnel plot of comparison: 3 Strong opioids compared to placebo, outcome: 3.4 Disability.
[Analysis 1.1]
Analysis 1.1. Comparison 1 Tramadol compared to placebo, Outcome 1 Pain intensity (higher score means worse pain levels).
[Analysis 1.2]
Analysis 1.2. Comparison 1 Tramadol compared to placebo, Outcome 2 Disability (higher ratings mean greater disability).
[Analysis 1.3]
Analysis 1.3. Comparison 1 Tramadol compared to placebo, Outcome 3 Side effects.
[Analysis 2.1]
Analysis 2.1. Comparison 2 Buprenorphine compared to placebo, Outcome 1 Mean pain intensity.
[Analysis 2.2]
Analysis 2.2. Comparison 2 Buprenorphine compared to placebo, Outcome 2 At least 30% of pain relief or moderate improvement.
[Analysis 2.3]
Analysis 2.3. Comparison 2 Buprenorphine compared to placebo, Outcome 3 At least 50% of pain relief.
[Analysis 2.4]
Analysis 2.4. Comparison 2 Buprenorphine compared to placebo, Outcome 4 Disability (higher ratings mean greater disability).
[Analysis 3.1]
Analysis 3.1. Comparison 3 Strong opioids compared to placebo, Outcome 1 Mean pain intensity.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Strong opioids compared to placebo, Outcome 2 At least 30% of pain relief or moderate relief.
[Analysis 3.3]
Analysis 3.3. Comparison 3 Strong opioids compared to placebo, Outcome 3 At least 50% of pain relief.
[Analysis 3.4]
Analysis 3.4. Comparison 3 Strong opioids compared to placebo, Outcome 4 Disability.
[Analysis 3.5]
Analysis 3.5. Comparison 3 Strong opioids compared to placebo, Outcome 5 Side effects.
[Analysis 4.1]
Analysis 4.1. Comparison 4 Opioids (all types) compared to placebo, Outcome 1 Mean change in pain intensity in enriched design trials (higher changes indicate less favourable scores).
[Analysis 4.2]
Analysis 4.2. Comparison 4 Opioids (all types) compared to placebo, Outcome 2 Side effects.
[Analysis 5.1]
Analysis 5.1. Comparison 5 Tramadol compared to celecoxib, Outcome 1 At least 30% of pain relief or moderate improvement.
[Analysis 6.1]
Analysis 6.1. Comparison 6 Opioids (all types) compared to antidepressants, Outcome 1 Pain (higher score means worse pain level).
[Analysis 6.2]
Analysis 6.2. Comparison 6 Opioids (all types) compared to antidepressants, Outcome 2 Disability (higher ratings mean greater disability).