Medications are almost always part of each treatment regimen for acute and chronic pain and may be combined with physical therapy and/or chiropractic care.
Your physician may prescribe one or more various types of medications to treat a variety of conditions including acute pain, chronic pain, herniated disc, disc degeneration, whiplash, facet and sacroiliac joint pain, stenosis, and spondylolisthesis.
The medications may be taken orally or possibly injected. Often, back pain medication use is combined with physical therapy and/or chiropractic care.
Medications are almost always part of each treatment regimen for acute and chronic pain. Your physician will select the correct medication mix based on your individual’s needs.
- Over-the-counter, medications are readily available and frequently effective in mild to moderate pain.
- Multiple nonsteroidal anti-inflammatory drugs are available to reduce inflammation but can also reduce pain.
- Muscle relaxants medication can reduce the painful symptoms while healing and allow treatment to occur.
- Opiate pain medications must be used with great care and supervision.
- Corticosteroid compounds can be delivered orally or by injection when anti-inflammatory drugs are not enough.
- Anticonvulsants have been shown recently to be effective for nerve and neuropathic pain.
- For persistent pain, steroids may be injected directly into a specific area of the spine to facilitate healing.
Frequently Asked Questions
- Over the counter, medications is readily available and frequently effective in mild to moderate pain. They include Tylenol, aspirin, ibuprofen, naproxen, and numerous topical agents. These have been shown to be safe in most people at dosages approved for over-the-counter use.
- NSAIDS – These are nonsteroidal anti-inflammatory drugs. There are many to choose from including ibuprofen, naproxen, etodolac , diclofenac, Nabumetone , meloxicam, and others. There is a subclass of these called COX-2 inhibitors which are much less likely to cause gastritis and ulcers. All of these medications aim to reduce inflammation but also can help to reduce pain. They are commonly used in arthritic conditions but also in pain syndromes.
- Muscle relaxants- Muscle tension and muscle spasm are commonly associated with pain whether the pain is due to muscle and soft tissue injury or other structural abnormalities. These muscle symptoms can be severe and incapacitating. Muscle relaxer medication can reduce the symptoms while healing and treatment can occur. They include agents such as tizantidine, methocarbamol, carisprodal, cyclobenzaprine, metaxalone, and baclofen. They all may cause sedation to varying degrees. Alcohol use is strongly discouraged with these drugs.
- The most common type of pain medication are opiates, which are compounds related to the morphine family. These are tramadol, codeine, hydrocodone, Hydromorphone, morphine, oxycodone, Oxymorphone, methadone to name a few. They all can have side effects such as sedation, constipation, and nausea. To varying degrees, they all are potentially addictive psychologically and/or physically. They must be used with great care and supervision of the physician. As of this date, the standard of care but also state and federal regulations now require documentation and surveillance for these drugs that includes medication contracts, urine drug testing, pill counts, functional improvement, and close follow-up. Alcohol use is strongly forbidden with these drugs.
- Corticosteroids- Cortisone compounds can be used when non-steroidal anti-inflammatory drugs are not enough. They can be given orally or by injection. They can be highly effective but their use is limited by potential long-term adverse effects including weight gain, osteoporosis, fractures, diabetes, and hypertension.
- Anticonvulsants- these are medications originally prescribed for seizures but have been shown in recent years to be effective for nerve pain, neuropathic pain. They include carbamazepine, gabapentin,Pre-Gabalin, and others. They must be prescribed for several weeks and may require increased dosages to be effective. They have been helpful for pain numbness and weakness.
- If your pain persists after physical therapy and oral medications, a steroid may be injected directly into a specific area of the spine, such as a facet joint.
- It is important that you inform your doctor of any medication you are currently taking, including over-the-counter, herbals, vitamins, minerals, and nutritional supplements. Some of these may have an undesirable interaction with other back pain medications or influence their ability to help your problem.