Medications

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Back and neck pain can be miserable!  Injury, herniated disc, spinal stenosis, osteoarthritis, vertebral compression fracture, or a simple back sprain can cause life-altering pain.  Back pain is one of the most common reasons people seek medical care.  Medications can help control pain and drugs may be combined with other therapies to maximize relief.

Yesterday vs. Today

Years ago patients with back pain were told to get off their feet and stay in bed for a week.  However, scientific study proves inactivity does little to resolve back pain.  Instead, pain treatments and physical therapy helps patients to get back on their feet.  Physical therapy teaches patients how to be flexible and strong, while learning about proper posture, biomechanics, and back pain prevention.

Medication - Overview

List below are common types prescription and over-the-counter or (OTC) drugs your physician may recommend to treat pain symptoms.  Sometimes, drugs are combined to be more effective. Your physician is your best source for information about drugs, including what can and cannot be combined.

Type of medication and its purpose:

• Narcotics (opioids): Short-term control of acute pain
• Muscle relaxants:  Relieves muscle spasms and cramping
• Non-steroidal anti-inflammatory drugs (NSAIDs): Reduces inflammation and pain
• Acetaminophen: Reduces inflammation and pain
• Sedatives: Promotes sleep
• Transdermal analgesics: Pain medication delivered through a skin patch

Narcotics (opioids)

Narcotics (pain killers) are prescribed for a short time to control acute pain.  Acute pain is often severe and sharp.  Long-term use of narcotics cause drug tolerance, meaning it takes a larger dose to control the same level of pain. Long-term opioid therapy requires close medical supervision.

Muscle Relaxants

Muscle relaxants help relieve muscle tightness, spasms, and cramping.  Acting on the central nervous system, these drugs have a sedating effect.

Non-steroidal Anti-inflammatory Drugs (NSAIDs)

Many spinal disorders cause soft tissue inflammation.  A herniated disc can cause spinal nerve inflammation and pain.  Whiplash or overuse injuries also effect soft tissues and cause swelling and muscle pain. NSAIDs help reduce inflammation and pain. Many NSAIDs are available over-the-counter however, that does not mean they are harmless. It is important to follow dosing instructions carefully. Long-term NSAID therapy requires close medical supervision.

Acetaminophen

Acetaminophen is available over-the-counter and combined in prescription drugs.  Acetaminophen is most effective on mild to moderate pain.  It has an anti-inflammatory effect too. Although widely used and recommended, acetaminophen is safe when taken at or below recommended doses. Since acetaminophen is contained in many products (both prescription and over-the-counter), it is easy to accidentally exceed recommended doses. Follow dosing instructions and check the labels on all drug products to determine if the product contains acetaminophen (known as paracetamol or APAP). When in doubt, a pharmacist or physician can provide advice.

Sedatives

Back or neck pain can make sleep difficult.  A prescription sedative to help.  These drugs should not be taken long-term, as many are habit-forming.

Transdermal Analgesics

Certain pain-relieving drugs are available in transdermal (skin) patch form.  The drug is released through the skin over time.  Transdermal patches help some patients avoid gastrointestinal consequences of oral medication.

Side Effects

Whether your medication is prescribed (Rx) or over-the-counter (OTC), there are risks -- side effects, drug interactions, and liver damage.  Therefore, be sure to tell you doctor about your allergies, current medications taken (Rx and OTC), and vitamin and herb use.  When you obtain a new medication, take time to read the information provided by your pharmacist or on the label. 

Always report side effects to your physician:

• Black, tarry stools                 
• Behavioral changes             
• Cold, clammy skin                 
• Hallucinations           
• Facial swelling               
• Fast or slow heartbeat           
• Hives, skin rash, itching
• Severe confusion or fatigue
• Severe weakness
• Trouble breathing
• Difficulty urinating
• Yellowing of the skin or eyes

Conclusion

Pain control is essential. It improves quality of life, enhances mobility, and enables more effective participation in rehabilitation. There are many options to manage pain, including, but not limited to, medications. Pain relievers must be taken strictly according to medical instructions.