05 Jan Low Dose Naltrexone Fulfills the 4 “L’s”
In the May/June 2020 issue of Practical Pain Management, the authors conducted a retrospective case review of 35 patients treated with Low Dose Naltrexone for chronic pain. They found that 46% reported a 50% or better improvement in their pain or chose to continue LDN because of other improvement in their quality of life.
All the patients’ chief complaints were reported as affecting the cervical and/or lumbar spine, hip and/or sacroiliac regions, or a combination of these locations. Radiation of pain to the arms/shoulders/jaw was common for patients reporting cervical spine pain, and pain radiating into the legs or diffusely into the lower back area was common for hip, lumbar spine, and SI patients
Since patients in this study were receiving care at an interventional pain management practice, many had previously undergone interventional pain procedures including steroid injections, trigger point injections, and platelet-rich plasma (PRP) injections, as well as nerve blocks and radiofrequency ablation in the affected area(s).
During the observation period, many patients were taking and/or continued to take various other pain medications such as gabapentin, cyclobenzaprine, naproxen, tramadol, ibuprofen, Tylenol, etc., which were either providing insufficient relief or causing undesirable side effects. As a result of these relative treatment failures, patients were offered treatment with LDN. LDN Dosing ranged from 0.5mg to 4.5mg daily.
The authors stated that “the types of pathology/pain treated with LDN in this study was quite varied. However, the liberal application of LDN prescriptions across many different pathological pain states was intentional and should not necessarily be viewed as a negative. In other words, there are very few contraindications to trying LDN in patients suffering from almost any kind of pain, as long as the patient is not taking any form of opioid and does not have any other known contraindication for the use of LDN.”
A 46% response rate to LDN in this study is quite extraordinary when you factor in the types of patients in the study. These patients were being seen at an interventional pain clinic and had already failed steroid, PRP and trigger point injections or nerve blocks and RF ablation. They were also taking a myriad of other pain medications which were not providing adequate relief.
The 4 L’s – Low Risk, Low Side Effects, Low Cost, Low Dose
The authors of this study state that LDN fulfills the 4 L’s that many patients are looking for. We would also suggest that these 4 L’s also fulfill the characteristics of treatment options that you should consider when discussing treatment options with your provider.
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Jon Knab, MD. Et al. The Use of Low Dose Naltrexone in the Management of Chronic Pain. Prac Pain Mgmt. Volume 20, Issue #3. May/June 2020.