A Surprising Result

A Surprising Result

A Surprising Result

2

 

In July, 2015 a randomized trial commenced, comparing the results of Tylenol and Advil to opioids for acute pain. The results were surprising. A combination of the two worked just as well as opioids.

Let’s talk……

416 men and women who had an average pain score of 8.7 in their arms or legs from sprains, strains, fractures or other injuries. They were randomly assigned one of the drug combinations below. After 2 hours, they were asked what their pain level was. These are the results.

Oxycodone/acetaminophen (5/325)   4.4

Hydrocodone/acetaminophen (5/325) 3.9

Codeine/acetaminophen (30/300)   3.9

Ibuprofen/acetaminophen (400/1000)   4.3

The lead author, Dr. Andrew Chang, a professor of emergency medicine at Albany Medical College, states on average, even for severe pain of fractures, non-opioids worked just as well as the opioids more commonly prescribed.

Inclusion Criteria includes:

  • Complaint of acute pain of < 7 days duration
  • Location of pain in one or more extremities defined as distal to and including the shoulder joint in the upper extremities and distal to and including the hip joint in the lower extremities;
  • Radiologic evaluation is planned

 

Some exclusion Criteria includes:

  • Past use of Methadone
  • Chronic condition requiring frequent pain management
  • History of an adverse reaction to any of the study medications
  • Opioids taken in the last 24 hours
  • Ibuprofen or acetaminophen taken in the last 8 hours
  • Pregnancy/ Breastfeeding
  • History of Peptic ulcer disease
  • Reported use of prior use of narcotics
  • Medical condition that might affect the metabolism of medications
  • Taking of any medicine that might interact with one of the study meds.

Maybe it’s time to start looking at where a lot of addiction starts. Appropriate treatment from the start, can make all the difference in the patient’s future.

Citations

  • Lynch FL, McCarty D, Mertens J, Perrin NA, Green CA, Parthasarathy S, Dickerson JF, Anderson BM, Pating D. Costs of care for persons with opioid dependence in commercial integrated health systems. Addict Sci Clin Pract. 2014 Aug 14;9:16. PubMed PMID: 25123823

Submit a Comment

  1. I find this surprising. But it does make sense. When I have a major pain Tylenol or Advil always works better than Hydrocodone for me.

    1. They used a mixture of the two in this study. Though they both have side-effects, none of them are tolerance or addiction. Also if you ever require surgery, the opiate medications will work much better for you with no tolerance issues.

Leave a Reply

Your email address will not be published. Required fields are marked *

*
*

Disclosure Statement

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.

Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 
The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
Please note all articles, blogs and Q&A’s on this site are general information and are not to be used as medical advice for individuals. No specific diagnosis or treatment should be made based on this information. Only a physician can provide you with advice specific to your situation. Please followup with your physician if you would like to discuss your individual condition.

If you are having a medical emergency,  contact your Doctor immediately,  or go to the Emergency Room.
ShimSpine and ShimSpine.com is committed to honoring and respecting the privacy and anonymity of the individuals using its website(s) and/or services. The purpose of this Privacy Policy is to inform the individuals about the collection, processing and protection of information done by ShimSpine what information we collect, why we collect this information and how we use this information.

This Privacy Policy will be reviewed regularly to reflect the up-to-date practices of ShimSpine.