Information for Patients
What is Chronic Low Back Pain?
Chronic low back pain is defined as pain that lasts more than 3 months. The pain is located in the low back and can worsen with bending, sitting, or even turning over in bed. Sneezing or coughing can sometimes even make the pain worse. Occasionally, the pain can radiate to the buttocks or down a leg.
What Causes Low Back Pain?
There are many causes of low back pain and It can be due to strain of the muscles or ligaments of the back or injury to the bones or discs that comprise the spine. Often, we are unable to determine an exact event or injury responsible for chronic low back pain.
What Treatments Are Available for Chronic Low Back Pain?
Chronic back pain is a very common medical problem. Unfortunately, there are not many effective treatments for chronic low back pain (e.g. lasting more than 3 months). Sometimes the pain will improve on its own. Drug therapies such as non-steroidal anti-inflammatory drugs (NSAIDS) are common. Another common treatment for moderate to severe chronic back pain is the use of opioid pain medications. The purpose of our study is to determine if the use of these opioid medications changes people's pain sensitivity over time.
What Can I Expect if I Choose to Participate in the Stanford Back Pain Study?
Once we determine that you are eligible and enroll in our study, you will first be given a cost-free medical examination by our principal investigator, Dr. Larry Chu, MD, MS, Assistant Professor of Anesthesia at the Stanford University School of Medicine and Palo Alto Veterans Affairs Hospital or one of his colleagues. The purpose of the examination is to gather additional information regarding your past medical history and to perform a physical examination to ensure that you do not have any serious back problems that might require other more immediate interventions.
On the second appointment, we will perform two pain tests on you to determine your pain sensitivity to heat and cold pain. We will also start an IV and will give you a short-acting pain medicine while we perform these tests. These appointments are scheduled to start at 8am and are usually finished by 11am to noon. After we finish testing, we will give you a bottle of study medicine that may or may not contain opioid pain medicine (morphine). There is a 50-50 chance that you will receive sugar pills instead of morphine. We will give you instructions on how to take this medicine. We will then schedule your third and final appointment in 1 month. You can expect the final appointment to be similar to the previous session.
Will I be Paid to Participate in this Study?
The study is being sponsored by the National Institutes of Health. You will be paid $500 for your participation in this 1 month study.
I've Heard that Opioid Medicines such as Morphine are Addictive. Will I become Addicted to Morphine if I Participate in This Study?
While it is true that opioid medications have some potential for abuse, it is very unlikely that you will become addicted during this study for several reasons. First, the length of the study is limited to 4 weeks, after which you will be tapered off of your study medication (either placebo or active drug). It is unlikely that you will become addicted during this short period of time when you will be closely monitored by a physician. Second, addiction is very unlikely if you do not have a history of addiction or substance abuse.
