Medication For Back Pain

by Gavin Morrison on January 15, 2015

Medications for joint and muscle pain are either over the counter drugs (OTC) or prescription medications. Like most drugs, there are brand names and generic forms. Generic medications cost less. You can buy over the counter medications from the pharmacy without a prescription.  Patients should consult a physician if there is a need to take any kind of medication for more than a two-week period.


Common OTC pain medications:

Nonsteroidal anti-inflammatory drugs (NSAID) are most often used to control pain, including back pain. Taken in therapeutic (higher more frequent) doses they can also be effective at controlling inflammation. NSAIDs can cause stomach and digestive problems in some patients. NSAIDs should be taken with meals to help avoid these side effects. NSAIDs should not be used long term (more than 2 weeks) without consulting a physician.

Common OTC NSAIDs:

·    Aleve (Naproxen Sodium)
·    Advil (Ibuprofen)

High dosage prescription strength NSAIDs are prescribed for their anti-inflammatory properties. Higher dosage NSAIDs may have side effects such as nausea, constipation, diarrhea and sensitivity to light.

Some serious risks of long-term use of higher dose NSAIDs are:

·    Kidney damage. These medications are generally filtered and flushed out of the body through the kidneys. Patients over the age of 65 or those with kidney problems must first consult a physician before taking NSAIDs. Patients taking NSAIDs for six months or longer should have regular blood tests to check any developing kidney dysfunction.

·    Stomach problems. Stomach upset and sometimes stomach ulcers can occur with extended NSAID use. Patients with stomach ulcers should consult with their physician before taking NSAIDs. Symptoms can be intestinal bleeding marked by abdominal pain, black tarry stools, muscle weakness, or light-headedness when standing up.

NSAIDs have other risks and complications. While many side effects are rare, some can be serious. As with any medication, it is important to be under the care of a physician when taking NSAIDs at higher doses or for extended periods.

Patients with the following problems should consult a physician before taking NSAIDs:

·    Thyroid conditions
·    Diabetes
·    Heart disease
·    High blood pressure
·    Allergies to aspirin or other pain relievers
·    Breast feeding and/or pregnancy
·    Consuming in excess of three alcoholic beverages a day
·    Surgery (including dental surgery)

Acetaminophen, or Tylenol, is also a popular OTC medication used for relieving pain. Tylenol has no anti-inflammatory effects but is the safest choice for mild pain relief, especially for pregnant women. There are few side effects except for those that have a liver condition or liver damage from hepatitis. Further studies are being done on long-term effects of this medication on the liver.

Anacin, also called Paracetamol, is another OTC medication used for pain, although much less common.

Prescription Medications For Joint Or Spine Problems

Prescription medications include:

·    Muscle relaxors
·    Steroid anti-inflammatories
·    Pain killers
Muscle relaxors are prescribed for severe muscles spasms associated with back pain. Muscle spasm pain can range from mild to excruciating. When the muscles contract or start to spasm in reaction to problems in the spine these muscles can cut off their own blood supply. Reduced blood supply means there is less oxygen getting to the muscle cells. This is referred to as an ischemic condition in the muscle. This lack of oxygen to the muscle cells is what creates the intense pain associated with back spasms. Muscle relaxors help reduce the spasms in the back muscles which reduces the back pain.

Common prescription muscle relaxors:

Flexeril (Cyclobenzaprine) Skeletal Muscle Relaxant
Skelaxin (Metaxalone) muscle relaxant
Soma (Carisoprodol) muscle relaxant

Steroid Anti-inflammatories

Oral steroids are often prescribed to reduce severe inflammation. Such inflammation is often associated with a bulged or herniated disc in the lower back.  The nerve pain that often occurs with low back disc problems is generally due in part to inflammation of the surrounding ligaments and soft tissues. Reducing the inflammation in these tissues often helps to reduce pain and pressure on the nerve even when there is a disc bulge.
Oral steroids are sometimes used to control pain and inflammation around other joints as well. Controlling pain and inflammation allows patients to pursue conservative treatment such as physical therapy.

Oral steroids come in pill form in what is known as a Medrol Dose Pack. This regimen starts with a high dose of the steroid. The medication reduces inflammation and delivers some immediate pain relief. The dose is then tapered off over a period of five or six days.

There are numerous complications associated with chronic steroid use. Therefore, steroids are prescribed for short periods of time, usually one to two weeks. Frequently steroids are prescribed only when a patient experiences severe flair ups in their back or other joints.

The most commonly prescribed oral steroid is Prednisone (Methylprednisolone)

Narcotic Medications For Back Pain

Narcotics can be very effective at killing pain, however they are highly addictive if taken for extended periods. In addition patients can develop a tolerance to the medication making the initial dosage less effective thus requiring higher doses over time. Because they are addictive these medications are generally prescribed only for intense pain from injuries or after surgery. Except in cases of intractable (unstoppable) pain they are only prescribed for short periods (2 weeks or less).

These drugs work on the receptors in the brain that are associated with processing pain signals coming from the body. As with most prescription medications they can have numerous side effects. It is important to discuss these side effects with the prescribing physician.

Prescription Drugs Commonly Prescribed For Severe Pain

OxyContin Oxycodone Hydrochloride.
Percocet Oxycodone Hydrochloride & Acetaminophen.
Vicodin Acetaminophen and Hydrocodone.

Ultram (Tramadol). This medication is a non-narcotic painkiller that is stronger than Tylenol (acetaminophen) but is not a narcotic medication.
Ultracet has both Tramadol and Acetaminophen. Patients who take Ultracet should not take acetaminophen (Tylenol).

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