Rath S. Advancing chronic low back pain management: Insights from amitriptyline and duloxetine comparison. World J Methodol 2026; 16(1): 113191 [DOI: 10.5662/wjm.v16.i1.113191]
Corresponding Author of This Article
Shree Rath, MD, Department of Medicine, All India Institute of Medical Sciences Bhubaneswar, Sijua, Patrapada, Bhubaneswar 751019, Odisha, India. shreerath4a@gmail.com
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Medical Laboratory Technology
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Letter to the Editor
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 20, 2026 (publication date) through Feb 10, 2026
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World Journal of Methodology
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2222-0682
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Rath S. Advancing chronic low back pain management: Insights from amitriptyline and duloxetine comparison. World J Methodol 2026; 16(1): 113191 [DOI: 10.5662/wjm.v16.i1.113191]
World J Methodol. Mar 20, 2026; 16(1): 113191 Published online Mar 20, 2026. doi: 10.5662/wjm.v16.i1.113191
Advancing chronic low back pain management: Insights from amitriptyline and duloxetine comparison
Shree Rath
Shree Rath, Department of Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar 751019, Odisha, India
Author contributions: Rath S was responsible for conceptualization, data curation, writing and review of the manuscript.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shree Rath, MD, Department of Medicine, All India Institute of Medical Sciences Bhubaneswar, Sijua, Patrapada, Bhubaneswar 751019, Odisha, India. shreerath4a@gmail.com
Received: August 19, 2025 Revised: September 14, 2025 Accepted: November 18, 2025 Published online: March 20, 2026 Processing time: 176 Days and 5.5 Hours
Abstract
Chronic low back pain (CLBP) is a leading cause of disability worldwide, yet optimal pharmacological management remains debated. This letter to the editor appraises the observational study by Sardar et al, which compared amitriptyline and duloxetine in a tertiary rehabilitation setting. The study, involving 254 patients, demonstrated that amitriptyline provided rapid early pain relief, while duloxetine offered more sustained pain reduction at 12 weeks with fewer anticholinergic and sedative side effects. These findings are consistent with existing evidence supporting duloxetine’s efficacy and tolerability in chronic pain management. Although the absence of a placebo group limits causal inference, the study underscores the importance of individualized treatment strategies. We recommend further randomized controlled trials to validate these findings and strengthen evidence-based guidelines for CLBP management.
Core Tip: This manuscript highlights the comparative effectiveness of amitriptyline and duloxetine for chronic low back pain (CLBP). While amitriptyline provides rapid early pain relief, duloxetine offers more durable reduction with fewer side effects, making it preferable for sustained management. The study’s real-world approach, using robust statistical adjustments and patient-centered outcomes, emphasizes the importance of personalized treatment strategies in chronic pain. These findings support duloxetine as a promising option and underscore the need for further randomized trials to refine evidence-based guidelines for CLBP management.
