True Functional Restoration and Analgesia in Non-Radicular Low Back Pain
Back Pain Lower Back Chronic, Chronic Pain
About this trial
This is an interventional treatment trial for Back Pain Lower Back Chronic focused on measuring pain
Eligibility Criteria
Inclusion Criteria:
Meets our criteria for CNRBP:
- Pain of 3 months or more duration
- non-radiating (below buttocks or above lower back pain)
- no decreased sensation or allodynia/hyperalgesia in a radicular pattern
- no reflex asymmetry
- no frank weakness or atrophy
- no non-pain sensory or reflex changes
- If female, not pregnant or breast feeding, and not currently attempting to conceive; if of childbearing potential, use of a highly effective method of birth control (as determined by Pl).
- Able to read and speak English and provide informed consent.
- Age 18-65.
- Able to understand and comply with all data collection methodology, and demonstrated ability to manage the electronic diary system (as tested in 'detox' and baseline/SBPLI period).
- Subjects may continue any non-opioid stable scheduled drug regimen with no changes during the course of study, hydrocodone/acetaminophen 5/325 up to two doses per day along with Tylenol 2g/day are the only allowed rescue medications. Subjects are asked not to use the rescue medication 12 hours or less before testing.
- Subjects taking opioids must agree to 'detoxify' for the protocol under the supervision of the study medical personnel. Subjects may use hydrocodone/acetaminophen 5/325 twice daily for breakthrough pain, as provided to them during the study, and must use only the hydrocodone/acetaminophen provided (with a pill count is a secondary outcome)
- Subjects must agree to try to stay as functional as possible (defined by only tolerable increase in pain with function or function testing)
- Must have 'average' pain greater than or equal to 4 and no greater that 9 on a 10-point NRS scale at phone screening and first visit
- Subjects must have and maintain a working phone
CMP, CBC, UDS, EKG within normal limits at the discretion of the PI.
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Exclusion Criteria:
- Subjects with hypersensitivity to Opioids, Acetaminophen, buprenorphine or Belbuca®
- Subjects taking equal to or more than 100 morphine milliequivalents,
- Subjects with severe or untreated psychiatric disturbance (e.g. mania, depression [esp suicidality], anxiety, substance use disorder etc). This exclusion at the discretion of the PI.
- A known or admitted history of opioid abuse, diversion or addiction.
- Subjects with severe, ongoing or unaddressed medical conditions (e.g. Renal or Hepatic disease i. [creatinine>1.5 ml/dl; AST or ALT> 2x normal limit], severe or uncontrolled hypertension, pulmonary ii. disease, seizure disorder or gastroparesis or urinary retention.
- Subjects with a clinical diagnosis of fibromyalgia, polymyalgia rheumatica, spinal stenosis or non-osteoarthritis i. rheumatologic disease or severe chronic pain disorder of other body regions.
- Subjects who are currently talking MAO inhibitors (must have been off for > 14 days)
- Subjects with planned surgery or invasive/interventional procedures.
- Subjects must be willing to comply with visit and phone contact schedule, and try to stay as active and 'functional' as they can.
Subjects cannot be involved in any litigation concerning Workers Compensation or lawsuit concerning injury.
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Sites / Locations
- Carolinas Pain InstituteRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Placebo Comparator
Active drug arm
Placebo arm
Subjects who meet eligibility criteria and complete a single blind placebo lead in will be provided placebo buprenorphine buccal film that mimics the actual drug comparator and is continued by a blinded individual throughout the duration of the trial.
Subjects who meet eligibility criteria and complete a single blind placebo lead in will be provided active buprenorphine buccal film that is titrated to the effective dose and continued by a blinded individual throughout the duration of the trial.