Back Pain Management Techniques

Back pain treatments may involve exercises or procedures designed to eliminate the cause of a person's back pain, or they may involve back pain management techniques designed to minimize the amount of pain and inflammation associated with more chronic conditions. There are many options for treating and managing pain, as listed below.

Pain medications. The following medications available that directly or indirectly address the symptoms of pain include steroidal anti-inflammatory drugs, anticonvulsants, antidepressants, and opioids. There are the medications that are taken orally, either in pill or capsule form. Of the drugs listed, only nonsteroidal anti-inflammatory drugs (NSAIDs) are available over the counter. NSAIDs include the familiar medications available at your local grocery and drugstore: aspirin, Lodine, ibuprofen, and naproxen. These drugs, though available over the counter and given to you by your mother when you were a kid, can be dangerous when you exceed the recommended doses as listed on the bottle or take them continuously for more than a month. These medications are also available by prescription. I'm not sure why these medications are also available by prescription, other than the fact that it reduces the price this way for people with good insurance.



The primary clinical purpose these medications serve is blocking the release of prostaglandins which are involved in initiating the inflammatory process due to injury. When NSAIDs do not provide enough pain relief or inhibition of inflammation, patient may be prescribed steroidal anti-inflammatory medication, also for pain and inflammation. Commonly prescribed steroids include triamcinolone, prednisone, prednisolone, and cortisone. The active ingredient is a synthetic form of cortisole, which are normally produced by the adrenal glands in the human body. The hormone cortisone regulates the release of both prostaglandins and leukatrienes, which are released by cells in response to injury. While this response to injury is beneficial to injuries that involve a true healing and regeneration, chronic inflammation to joints that will have something wrong with them no matter what can lead to a wasting away of the bone around the damaged joints. For this reason, doctors may want to prescribe steroidal medications to control chronic inflammatory conditions such as osteoarthritis, rheumatoid arthritis, and Ankylosing Spondylitis.

For patients with neuropathic pain, certain nerves in the body may continue to fire pain signals to the brain in the absence of an injury where the nerve fibers originate. Neuropathic (nerve pain) may originate as an appropriate response to a somatic injury in the joints only to continue to fire pain signals after the injury has resolved itself. Other instances of nerve pain may be due to a disease condition in the body, such as Lyme disease, Hepatitis, and Multiple Sclerosis. In other conditions, degenerative joint or degenerative orthopedic conditions may cause the pressure on the nerve roots as they exit the spine or when they are near soft tissues that have changed. For conditions where patients are in severe pain due to nerve damage or nerve compression, nerve destruction may be ordered by the doctor. Nerve destruction involves the removal or destruction of the nerves that don't have an apparent pain generator, or cause of pain. Nerve destruction is done by a doctor, either by surgical removal, or a process called radiofrequency ablation. With radiofrequency ablation, heat is delivered to sensory nerves and the supportive structures of the nerve. Often, these nerves do regenerate themselves over time, though they may provide patients with several months of back pain relief or longer.