Off-label, Low-Dose Naltrexone for Refractory Chronic Low Back Pain
Naltrexone is a long-acting medication that competes at the opioid antagonist. Typically, it is used for treatment of narcotic addiction at a dose range of 20-80 mg/day. At lower doses, 1-5 mg per day, naltrexone can be used to treat chronic pain and autoimmune disorders. This article discuses a case in which low-dose naltrexone (LDN) was used to improve paraspinal pain in a 35 year old male. Previously, the patient was treated with several short-acting opioid analgesics, physical therapy, and corticosteroid injections, all of which were not effective. Several questionnaires and labs were used to evaluate the effectiveness of the LDN. Treatment started at 2mg and was raised to 4 mg. At the patient’s final follow-up, the patient was experiencing minimal pain and was able to participate in all daily physical activity.
Summary by Erin Williams, student, St. Louis College of Pharmacy