How to Assess and Manage Acute and Chronic Low Back Pain

Opioid treatment does have its place, however. That being said, there are still a variety of precautions clinicians should take before prescribing painkillers to patients, Dr. Pryzbylkowski said.

“While opioid medications can help with back pain, especially an acute episode of back pain, these medications play a lesser role in chronic back pain,” he said. “Physicians should be aware of the potential for adverse reactions from opioids—sedation, respiratory depression, nausea, mental status changes—as well as risk of addiction or misuse.”

There are potential adverse effects to consider when prescribing opioids for long-term pain, which is why clinicians do not typically prescribe them to this patient group. “There is minimal evidence that long-term opioid use for chronic back pain improves overall pain or function,” he said. “Opioids should be prescribed with caution and used for short-term, finite periods of time.”

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Alternative medications used for both acute and chronic low back pain fall into several categories: muscle relaxants, neuropathic agents, and anti-inflammatory agents. Other treatments include physical therapy, appropriate interventional pain procedures, acupuncture, yoga, and cognitive behavior modalities, Dr. Pryzbylkowski noted. 

“It is important to treat chronic low back as a chronic medical condition that will require lifelong treatment,” he said. 


  1. National Institute of Health. Low back pain fact sheet: National Institute of Neurological Disorders and Stroke (NINDS). Updated August 3, 2015. Accessed September 2, 2015.

This article originally appeared on MPR