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KMID : 1189320160100040685
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Asian Spine Journal
2016 Volume.10 No. 4 p.685 ~ p.689
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Low-Dose Tramadol and Non-Steroidal Anti-Inflammatory Drug Combination Therapy Prevents the Transition to Chronic Low Back Pain
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Inage Kazuhide
Orita Sumihisa
Yamauchi Kazuyo
Suzuki Takane
Suzuki Miyako
Sakuma Yoshihiro
Kubota Gou
Oikawa Yasuhiro
Sainoh Takeshi
Sato Jun
Fujimoto Kazuki
Shiga Yasuhiro
Abe Koki
Kanamoto Hirohito
Inoue Masahiro
Kinoshita Hideyuki
Takahashi Kazuhisa
Ohtori Seiji
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Abstract
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Study Design: Retrospective study.
Purpose: To determine whether low-dose tramadol plus non-steroidal anti-inflammatory drug combination therapy could prevent the transition of acute low back pain to chronic low back pain.
Overview of Literature: Inadequately treated early low back pain transitions to chronic low back pain occur in approximately 30% of affected individuals. The administration of non-steroidal anti-inflammatory drugs is effective for treatment of low back pain in the early stages. However, the treatment of low back pain that is resistant to non-steroidal anti-inflammatory drugs is challenging.
Methods: Patients who presented with acute low back pain at our hospital were considered for inclusion in this study. After the diagnosis of acute low back pain, non-steroidal anti-inflammatory drug administration was started. Forty patients with a visual analog scale score of >5 for low back pain 1 month after treatment were finally enrolled. The first 20 patients were included in a non-steroidal anti-inflammatory drug group, and they continued non-steroidal anti-inflammatory drug therapy for 1 month. The next 20 patients were included in a combination group, and they received low-dose tramadol plus non-steroidal anti-inflammatory drug combination therapy for 1 month. The incidence of adverse events and the improvement in the visual analog scale score at 2 months after the start of treatment were analyzed.
Results: No adverse events were observed in the non-steroidal anti-inflammatory drug group. In the combination group, administration was discontinued in 2 patients (10%) due to adverse events immediately following the start of tramadol administration. At 2 months, the improvement in the visual analog scale score was greater in the combination group than in the non-steroidal anti-inflammatory drug group (p<0.001).
Conclusions: Low-dose tramadol plus non-steroidal anti-inflammatory drug combination therapy might decrease the incidence of adverse events and prevent the transition of acute low back pain to chronic low back pain.
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KEYWORD
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Spine, Low back pain, Tramadol, Anti-inflammatory agents, non-steroidal
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