Mild pain medications can reduce inflammation
and pain when taken properly. Pain medications
cannot stop the effects of aging and wear
and tear on the spine. But they can help control
pain. If you are pregnant, you should not
take any medication unless you have discussed
it with your obstetrician.
General Tips
* Medications should be used wisely. Take
them exactly as prescribed by your doctor
and report any side effects.
* Some pain medications are highly addictive.
* Pain medication is less effective for controlling
chronic pain if used over a long period.
* Medication will not "cure" pain of degenerative
origin.
Aspirin compounds are over-the-counter medications
that can help relieve minor pain and back
ache. The main potential side effect with
aspirin is the development of stomach problems-
particularly ulcers with or without bleeding.
NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs)
include over-the-counter pain relievers such
as ibuprofen and naproxen. These medications
were once only available by prescription.
NSAIDs are very effective in relieving the
pain associated with muscle strain and inflammation.
Be aware that NSAIDs can decrease renal function
if you are an older patient. Excessive use
can lead to kidney problems.
COX-2
Inhibitors
A new class of NSAIDs is gaining wide acceptance
in its ability to reduce inflammation. Commonly
called COX-2 inhibitors, these newer NSAIDS
work by selectively blocking the formation
of pain-causing inflammatory chemicals. COX-2
inhibitors appear to be easier on the stomach,
mainly because they don't interrupt stomach
enzymes like traditional NSAIDs. Celecoxib
(Celebrex®) is commonly prescribed
COX-2 inhibitor.
Non-narcotic
Prescription Pain Medications
Non-narcotic analgesics (pain relievers) are
ideal in the treatment of mild to moderate
chronic pain. Tylenol™ and aspirin are
the most widely used over-the-counter analgesics.
Medications that are analgesics and require
a prescription from the doctor include NSAIDs,
such as carprofen, fenoprofen, ketoprofen,
and sulindac. To reduce side effects do not
lie down for 15 to 30 minutes after taking
the medication, avoid direct sunlight, and
wear protective clothing and sun block. Avoid
using these medications if you have recurrent
ulcers or liver problems.
Narcotic
Pain Medications
If you experience severe pain, your doctor
might prescribe a narcotic pain medication
such as codeine or morphine. Narcotics relieve
pain by acting as a numbing anesthetic to
the central nervous system. The strength and
length of pain relief differs for each drug.
Narcotics can have side effects such as nausea,
vomiting, constipation, and sedation (drowsiness).
These side effects are predictable and can
often be prevented. Common preventive measures
include not taking sleeping aids or anti-depressants
along with narcotics, avoiding alcohol, increasing
fluid intake, eating a high fiber diet, and
using a fiber laxative or stool softener to
treat constipation. Remember that narcotics
can be addictive if used excessively or improperly.
Muscle
Relaxants
If you are having muscle spasms, muscle relaxants
may help relieve pain. They have only been
shown to be marginally effective. Muscle relaxants
also have a significant risk of drowsiness
and depression. Long-term use is not suggested;
only three to four days is typically recommended.
Anti-depressants
Back pain is a common symptom of depression
and could be an indicator of its presence.
Similarly back pain can lead to emotional
distress and depression. It seems that the
same chemical reactions in the nerve cells
that trigger depression also control the pain
pathways in the brain. Anti-depressants can
relieve emotional stress associated with back
pain. Some anti-depressant medications seem
to reduce pain-probably because they affect
this chemical reaction in the nerve cells.
Some types of anti-depressants make good sleeping
medications. If you are having trouble sleeping
due to your back pain, your doctor may prescribe
an anti-depressant to help you get back to
a normal sleep routine. Anti-depressants can
have side effects such as drowsiness, loss
of appetite, constipation, dry mouth, and
fatigue.
