Taking prescription narcotic painkillers doesn't improve movement or reduce disability in people with pain related to nerve damage from causes such as diabetes.
Diabetes and pinched nerves
"Even though narcotic medications can be a powerful pain killer, it does not necessarily mean improved function will follow. Pain is not the only factor in determining function," study lead author and pain expert Geoff Bostick, an associate professor of physical therapy at the University of Alberta in Canada, said in a university news release.
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The research included almost 800 patients with pain due to nerve damage, from causes such as diabetes and pinched nerves. Some were prescribed narcotic painkillers such as morphine, codeine and Tylenol 3 while others didn't receive the drugs.
At 6-month and 12-month follow-ups, those who took the painkillers didn't show greater improvements in movement and disability than those who did not take the drugs, the investigators found.
"It can be difficult helping people move when they have pain, but as a physiotherapist I know the importance of physical function and we have to help find a way to promote movement, even if it is painful," Bostick said.
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"Pain is very complex, and people experience pain at very different levels," he added. Narcotic painkillers "can help people with severe pain be more comfortable, but if they are not also facilitating improved function, the impact of these medications on quality of life should be questioned".
Stop before pain gets too bad
If chronic pain patients have gotten the OK for physical activity from their doctors, Bostick advised taking a gradual approach.
"If you want to move better, it requires careful measurement of your tolerance to activity," he said. "Instead of say, walking until you reach your pain limit, I tell patients to walk until they are at 50 percent of their tolerance walk and stop before the pain gets too bad.
Each week, walking time is gradually increased. Over time, this tolerance will slowly increase and so will physical function."
The study was published recently in the journal Pain Medicine.
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