Prevalence and characteristics of breakthrough pain in patients receiving opioids for chronic back pain in pain specialty clinics

• Published in: Journal of opioid management Vol. 3; no. 2; p. 101
• Main Authors: Bennett, Daniel S, Simon, Steven, Brennan, Michael, Shoemaker, Steven A
• Format: Journal Article
• Language: English
• Published: United States 01.03.2007
• Subjects: Adult; Aged; Algorithms; Analgesics, Opioid - therapeutic use; Back Pain - drug therapy; Back Pain - epidemiology; Back Pain - physiopathology; Chronic Disease; Data Collection; Female; Humans; Interviews as Topic; Male; Middle Aged; Pain Clinics - statistics & numerical data; Pain Measurement; Prevalence; Treatment Outcome; United States; United States
• ISSN: 1551-7489
• DOI: 10.5055/jom.2007.0046

We sought to assess the prevalence and characteristics of breakthrough pain (BTP) in patients with chronic back pain. Researchers utilized a telephone survey using a pain assessment algorithm. This report represents a subset of patients from a larger survey of 228 patients with chronic pain unrelated to cancer. This study employed 117 subjects taking opioids for a primary diagnosis of back pain and receiving care at geographically dispersed pain treatment centers. Subjects had pain lasting at least six months and had "controlled" baseline pain. Eighty-seven subjects (74 percent) experienced 93 types of BTP. The median number of BTP episodes per day was two; median time to maximum intensity was 10 minutes, and median duration was 55 minutes. Onset could not be predicted for 46 percent of pains. Eighty-three percent of subjects used shorter-acting opioids for BTP. Other medications used for pain included NSAIDs, antidepressants, anticonvulsants, skeletal muscle relaxants, intrathecal local anesthetics, and transdermal local anesthetics. These patients with opioid-treated chronic back pain commonly experienced BTP, which often had a rapid onset and a relatively short duration and was difficult to predict. Opioids were the mainstay of pharmacologic therapy, but nonopioid analgesics and adjuvant analgesics were commonly used.