If you've ever suffered from chronic low back pain, chances are you've either been prescribed or heard of gabapentin. It's often offered as a “safer” alternative to opioids for nerve-related back pain. But a new study suggests there may be more to consider, particularly when it comes to your memory.

A study has found that taking numerous prescriptions of gabapentin over time for ongoing back pain raises the risk of developing dementia or mild cognitive impairment (MCI). Specifically, people fitting this profile were 29 percent more likely to develop dementia and 85 percent more likely to be diagnosed with MCI within 10 years.

Dementia risk more than doubled among people from 35 to 49 years old who used gabapentin, and the risk of mild cognitive impairment more than tripled compared to non-users.

The results come from a study by researchers at Case Western Reserve University (CWRU) School of Medicine. The team tapped into a federal database containing anonymous health records from 68 U.S. healthcare organizations, TriNetX.

Over 26,400 adults aged 18 and older, all of whom had been prescribed gabapentin for low back pain and a control group of the same size with low back pain but no gabapentin prescriptions were included in the study.

The researchers tracked both groups for up to ten years, adjusting for variables like demographics, other health conditions and use of additional pain medicines.

Their results were striking:

  • Patients who had been prescribed gabapentin six or more times had a 29 percent higher risk of dementia and an 85 percent higher risk of cognitive impairment within a decade of diagnosis.
  • Dementia risk more than doubled among people from 35 to 49 years old who used gabapentin, and the risk of mild cognitive impairment more than tripled compared to non-users.
  • Even older adults (50-64) showed elevated risk.
  • People who had been prescribed gabapentin 12 or more times had a 40 percent increased dementia risk and a 65 percent higher risk of mild cognitive impairment compared to patients prescribed it from three to 11 times.

It's important to note that this is an observational study which means it can't definitively prove gabapentin causes cognitive decline. The authors acknowledge the study's limitations including lack of data on dosage and duration, as well as some factors that might contribute to the outcome such as less physical activity among chronic pain sufferers.

Still, the study's results are concerning. “Our findings indicate an association between gabapentin and dementia or cognitive impairment within 10 years,” Nafis Eghrari, the study's lead investigator and an associate professor at CWRU School of Medicine, said in a media release. “Moreover, increased gabapentin prescription frequency correlated with dementia incidence.”

While gabapentin has been the go-to for everything from nerve pain to restless legs, this new research sounds a wake-up call — especially for older adults.

Dr. Eghrari emphasized that these results don't establish cause and effect yet, but suggest that careful monitoring of patients on gabapentin is warranted.

What's the upshot? While gabapentin has been the go-to for everything from nerve pain to restless legs, this new research sounds a wake-up call — especially for older adults. The Case Western study doesn't slam the door shut on the drug, but it does push it open for more scrutiny. If you are regularly taking gabapentin, it may be time to have a conversation with your doctor.

Meanwhile, here are seven suggestions to reduce back pain without medication.

    1. Work on strengthening your core muscles.
    2. Stretch daily.
    3. Avoid sitting with poor posture.
    4. Take frequent walks.
    5. When lifting, engage your leg muscles not your back.
    6. When you sleep, elevate your knees slightly by putting a pillow under them to reduce pressure on your back.
    7. Watch your weight. Those extra pounds put a strain on your back.

The study is published in Regional Anesthesia and Pain Medicine.