The current Australian guidelines and standards for the management of spinal pain (low back and neck) need to be updated to reflect best available evidence and protect the public.
Opioids have been demonstrated to be clinically ineffective in the treatment of acute back and neck pain and have the potential to cause serious harm or even death. Despite this, current Australian guidelines still recommend their use. A recent randomised controlled trial that ran over six years (The OPAL study) found that opioids are less effective than placebo, with patients in the placebo group reporting significantly lower pain scores compared to the opioid group after one year. Additionally, the study revealed a higher risk of misuse among individuals who received opioids in the trial.
This paper argues for urgent action to update Australian standards and guidelines to explicitly prioritise non-pharmacological management of acute and chronic spinal pain, thus aligning with international guidelines and standards. The implications for chiropractors are discussed, emphasising their role in providing drug-free approaches to spinal pain management.
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