Medications for Back Pain: Analgesics
Analgesics: Analgesic medications are used purely for pain relief. That is, unlike most NSAIDs (nonsteroidal anti-inflammatory drugs), their primary purpose is not to work against joint pain inflammation. Analgesics are manufactured drugs that can be taken topically (absorbed through the skin) or consumed oral in pill form. The main typed of analgesics include acetaminophen (Tylenol), narcotic (opiod-based) medications, narcotic medications with acetaminophen.
Acetaminophen: The most commonly used and readily available oral analgesic is acetaminophen (Tylenol). For many people, acetaminophen will be sufficient to provide enough short term relief to get patients by while they are healing from short-term injury. The analgesic Tylenol may be affective at mild to moderate back pain relief. Acetaminophen is often the active ingredient in products labeled "aspirin-free pain reliever" and will be found in all grocery stores, pharmacy stores, and bulk department stores such as Walmart and CostCo. Analgesics with acetaminophen as their main ingredient are available over-the-counter, while analgesics containing acetaminophen combined with opioid based ingredients such as Lortab and Hydrocet are only available by a doctor prescription.
Narcotic analgesics with acetaminophen: Patients recovering from back surgery, or from an injury causing moderate to severe pain may need a stronger pain reliever that acetaminophen alone can provide. For severe pain, recovery from surgery or a vertebral fracture, a physician may prescribe narcotic analgesics such as tramadol (Ultram) or oxycodone (Roxicodone, Oxycontin). Narcotic analgesics have active ingredients that are opioid based. These medications work by binding to opioid receptors, which results in increased pain tolerance and a decreased reaction to pain. A secondary effect of these narcotic agents is a feeling of euphoria, or high. The euphoria, caused by the medication, makes patients more prone to taking more then their prescribed dose, which makes these drugs susceptible to abuse. For this reason, doctors closely monitor their patients usage of opioid based narcotics.
Typically, most narcotic agents are combined with the analgesic acetaminophen. Acetaminophen amplifies the effect of the narcotic for added pain relief.
Topical Analgesics: If you are not comfortable with taking narcotic analgesics or experience significant pain relief from acetaminophen alone, then you might try topical analgesics which can be rubbed over the site of pain or injury to provide back pain relief. There are many types of analgesic balms, rubs, creams, and salves available over the counter that can be absorbed through the skin in order to sooth inflamed joints. Patients are more likely to try topical analgesics if they want to avoid some of the side effects caused by acetaminophen and NSAIDS, such as increased photosensitivity to light, upset stomach, and other gastrointestinal problems. These creams and rubs are used on joints such as the knees, hands, and hips, as well as the lower back. These topical creams are designed to primarily affect the joints closest to location where they are applied, minimizing the risk of systemic side effects. Examples of topical analgesics include Salicylates (Sportscreme, Flexall, Aspercreme), Counterritants, and Capsaicin.