title: Prevalence and characteristics of breakthrough pain in patients receiving opioids for chronic back pain in pain specialty clinics.
abstract: OBJECTIVE
  We sought to assess the prevalence and characteristics of breakthrough pain (BTP) in patients with chronic back pain.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Integrative Treatment Centers, Denver, Colorado, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Bennett
authors.forename: Steven
authors.initials: S
authors.lastname: Simon
authors.forename: Michael
authors.initials: M
authors.lastname: Brennan
authors.forename: Steven A
authors.initials: SA
authors.lastname: Shoemaker
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001416:Back Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D002908:Chronic Disease; D003625:Data Collection; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D018710:Pain Clinics / Q000706:statistics & numerical data; D010147:Pain Measurement; D015995:Prevalence; D016896:Treatment Outcome; D014481:United States
chemical_list: D000701:Analgesics, Opioid