Gabapentin Not Effective for Chronic Low Back Pain

SAN DIEGO — The pain medication gabapentin appears to be no more effective than placebo at treating chronic low back pain, according to a study led by the VA San Diego Healthcare System.

The article was published online by the journal Pain. For the blinded study, researchers randomly assigned 108 patients with chronic back pain to either gabapentin or placebo — both packaged in identical gelatin capsules.1

Gabapentin, marketed as Neurontin and some other brands, primarily is used to treat seizures but also is recommended in some clinical practice guidelines as a first-line treatment for neuropathic pain. That’s why some physicians opt to prescribe it for low back pain.

After using gabapentin or a placebo in the same amounts and frequency during the 12-week study, participants completed questionnaires about pain intensity, mood and quality of life throughout the trial. Results indicate that pain intensity decreased significantly over time, with patients on gabapentin or placebo both reporting reductions of about 30% from baseline without significant differences.

Similar results occurred in terms of disability scores. The proportion reporting at least 30% or 50% reduction in pain intensity, or at least “minimal improvement” on the Physician Clinical Global Impression of Change was not significantly different when the two groups were compared. No meaningful variance was identified between participants with radiating and nonradiating pain, either within or between treatment arms.

Furthermore, the report noted no meaningful correlation between gabapentin plasma concentration and pain intensity.

“Gabapentin appears to be ineffective for analgesia in chronic low back pain with or without a radiating component,” study authors concluded.

1 Atkinson JH, Slater MA, Capparelli EV, Patel SM, et al. A randomized controlled trial of gabapentin for chronic low back pain with and without a radiating component. Pain. 2016 Mar 8. [Epub ahead of print] PubMed PMID: 26963844.

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