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Low back pain (LBP), both acute and chronic and with or without a radicular component, affects nearly all adults at some point, yet proven remedies are scant. Studies published in 2017 discouraged use of many common therapies and offered little new advice.
For example, to avoid use of opioids, pregabalin and gabapentin are prescribed widely by primary care physicians for patients with sciatica. However, in a placebo-controlled study of pregabalin (titrated to 600 mg daily for as long as 8 weeks) in patients with sciatica, pregabalin was ineffective (NEJM JW Gen Med Apr 15 2017 and N Engl J Med 2017; 376:1111). A meta-analysis that included six studies of gabapentin versus placebo or pregabalin versus another analgesic in patients with LBP (≈…