Journal of Neurology

, Volume 266, Issue 12, pp 3167–3170 | Cite as

Eighty years of Medication-Overuse Headache: what about Medication-Overuse Backpain?

  • Benjamin LuchtingEmail author
  • Jens Heyn
Short Commentary



Although chronic low back pain (CLBP) is one of the most common pain syndromes, up to now, clear pathophysiological causes or specific treatment options are missing. Medication-overuse has been associated with chronic headache, but never with CLBP.


Based on several similarities between CLBP and Medication-Overuse Headache (MOH), we hypothesized that medication-overuse might contribute to CLBP as well, maybe even as an own entity. Might there be something like Medication-Overuse Backpain (MOB)?


We substantiate our hypothesis with a preliminary case-series analyzing five patients suffering from CLBP with a marked medication-overuse. In these patients, a stepwise analgesic withdrawal was recommended.


Within 6 months of recruitment, five patients fulfilled the inclusion criteria and successfully completed discontinuation of their medication. All patients reported noticeable pain relief, despite the discontinuation of their analgesics. Withdrawal was well tolerated in all cases.


Considering our results, the described withdrawal method seems to be a simple and safe method to achieve pain reduction while simultaneously preventing organ damage. Despite the preliminary character of our results, our hypothesis might stimulate a new understanding of CLBP’s pathophysiology.


Pain Headache Medication-Overuse Headache Back pain 


Author contributions

All authors contributed to the case-series conception and design. Hypothesis and data collection were performed by BL. Conceptualization, data analysis, writing, review, and editing were performed by BL and JH. The first draft of the manuscript was written by BL, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical standards

The manuscript does not contain a clinical study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Interdisciplinary Pain CenterKlinikum Landsberg Am LechLandsberg am LechGermany
  2. 2.Department of Anesthesiology and Pain MedicineLudwig-Maximilians-University Munich (LMU)MunichGermany

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