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Eighty years of Medication-Overuse Headache: what about Medication-Overuse Backpain?

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Abstract

Introduction

Although chronic low back pain (CLBP) is one of the most common pain syndromes, up to now, clear pathophysiological causes or specific treatment options are missing. Medication-overuse has been associated with chronic headache, but never with CLBP.

Hypothesis

Based on several similarities between CLBP and Medication-Overuse Headache (MOH), we hypothesized that medication-overuse might contribute to CLBP as well, maybe even as an own entity. Might there be something like Medication-Overuse Backpain (MOB)?

Methods

We substantiate our hypothesis with a preliminary case-series analyzing five patients suffering from CLBP with a marked medication-overuse. In these patients, a stepwise analgesic withdrawal was recommended.

Results

Within 6 months of recruitment, five patients fulfilled the inclusion criteria and successfully completed discontinuation of their medication. All patients reported noticeable pain relief, despite the discontinuation of their analgesics. Withdrawal was well tolerated in all cases.

Conclusions

Considering our results, the described withdrawal method seems to be a simple and safe method to achieve pain reduction while simultaneously preventing organ damage. Despite the preliminary character of our results, our hypothesis might stimulate a new understanding of CLBP’s pathophysiology.

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Author information

Authors and Affiliations

  1. Interdisciplinary Pain Center, Klinikum Landsberg Am Lech, Bgm.-Dr.-Hartmann-Str. 50, 86899, Landsberg am Lech, Germany

    Benjamin Luchting

  2. Department of Anesthesiology and Pain Medicine, Ludwig-Maximilians-University Munich (LMU), Munich, Germany

    Benjamin Luchting & Jens Heyn

Authors
  1. Benjamin Luchting
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  2. Jens Heyn
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Contributions

All authors contributed to the case-series conception and design. Hypothesis and data collection were performed by BL. Conceptualization, data analysis, writing, review, and editing were performed by BL and JH. The first draft of the manuscript was written by BL, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Benjamin Luchting.

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Conflicts of interest

The authors declare that they have no conflict of interest.

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The manuscript does not contain a clinical study.

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Luchting, B., Heyn, J. Eighty years of Medication-Overuse Headache: what about Medication-Overuse Backpain?. J Neurol 266, 3167–3170 (2019). https://doi.org/10.1007/s00415-019-09611-7

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  • DOI: https://doi.org/10.1007/s00415-019-09611-7

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