title: [Altered pain thresholds during and after opioid withdrawal in patients with chronic low back pain].
abstract: BACKGROUND
  Opioids as the strongest pain drugs are often used for chronic pain although their long-term efficacy has not yet been clarified. In this longitudinal study, we compared the pain sensitivity of patients with chronic low back pain (cLBP) under long-term opioid use and treated with multidisciplinary pain therapy.
  
  
  METHODS
  The pain sensitivity was measured by the quantitative sensory testing (QST) technique at admission, discharge and 6 months after the beginning of the study in 34 patients with both cLBP and opioid medication, 33 opioid-naive cLBP patients and those neither with pain nor opioid use (HC). Both patient groups underwent a 3-week multidisciplinary pain therapy (MDPT).
  
  
  RESULTS
  Under opioid use, the patients showed significantly lower cold and heat pain thresholds compared to HC and delayed reaction to warm stimuli. After 3 weeks of MDPT, opioid-positive patients still had a lower pain threshold to cold and heat stimuli, while opioid-naive patients normalised their pain perception.
  
  
  CONCLUSIONS
  Our findings suggest that long-term use of opioids intensifies the peripheral sensitisation of cLBP. The MDPT can counteract this process.
authors.affiliation: Orthopädische Universitätsklinik Heidelberg, Schlierbacher Landstr. 69118 Heidelberg. haili.wang@med.uni-heidelberg.de
authors.forename: H
authors.initials: H
authors.lastname: Wang
authors.forename: N
authors.initials: N
authors.lastname: Weinsheimer
authors.forename: M
authors.initials: M
authors.lastname: Akbar
authors.forename: M
authors.initials: M
authors.lastname: Schiltenwolf
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008137:Longitudinal Studies; D017116:Low Back Pain / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects*; D009209:Myofascial Pain Syndromes / Q000188:drug therapy; D010147:Pain Measurement; D017288:Pain Threshold / Q000187:drug effects*; D010348:Patient Care Team; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000523:psychology
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine
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