Topics in Back Pain Medicine
The simple fact is that medications are used by patients because they work, because they sometimes provide immediate relief, and because they provide physical benefits that other back pain treatments don't. Most patients are savvy enough about medications to be aware of the risks that come with them, but most are also responsible and knowledgeable enough to be able to make informed decisions about when to use them safely.
When talking about and discussing back pain medications, there are many factors that must be considered. Despite the best efforts of the drug manufacturers during research and development, there are minuses associated with all medications. So not only do patients have to consider whether or not the medications will actually work or not, patient must also consider what harmful effects that they might have on their body. Common harmful side effects of back pain medications include gastrointestinal distress, bone density loss, dependence, and kidney damage. Indeed these are all pretty harmful side effects that would give anyone pause. Fortunately, these side effects are fairly rare as long as patients don't exceed the doses as listed on the bottle, and these medications aren't used as a long-term solution to a chronic condition.
The world of back pain medicine is fairly diverse, considering the many psychological and physical causes that may contribute to the patient's overall experience of pain. We are still beginning to understand how emotional health contributes to our experience of comfort or pain, but there are some things that we do know. People who have had traumatic experiences in their past, and people who are in poor states of mental health are more likely to experience back pain. People with long-term anxiety issues and depression are more likely to suffer from muscle conditions such as fibromyalgia and back spasms. People who have good coping skills in dealing with adversity and are happy in general are far less likely to suffer from chronic pain. For this reason, chronic pain conditions are commonly treated with anti-depression medications such as tricyclic antidepressants, Serotonin and norepinephrine reuptake inhibitors (SNRIs), and Selective serotonin reuptake inhibitors (SSRIs).
When dealing with pain conditions that have a root in a physical injury to the body, there are also a variety of medications that may be used to treat the patient's specific physical condition. Patients may be treated specifically to address the disease that caused the patient's condition, the structures of the body that are affected, and the part of the body that was affected. For example, the medications that are used to treat nerve pain are very different than the medications that are used to treat systemic inflammatory conditions, such as rheumatoid arthritis.
Let's take a look at some interesting topics in back pain medicine.
Anti-inflammatory medications: Non-steroidal anti-inflammatory medications (NSAIDs) are available over the counter, and they are usually the first line of defense for treating pain and minor soreness of orthopedic injuries. Though not technically a non-steroidal anti-inflammatory drug, Tylenol (acetaminophen) is another over the counter medication that is often used to manage acute pain. Because these medications are available without a prescription and are so familiar to all of us, many people assume that they are completely safe to take. Indeed, NSAIDs and acetaminophen is very safe when taken in the recommended doses and for short-term use only. But when these medications are taken for weeks or months, they have the potential of wearing down the lining of our GI tract. The GI tract runs the length of our body, from our esophagus, and through the small and large intestines. Other potential complications to long-term use include kidney and liver damage. If your back problem becomes a chronic condition, you are going to have to find another way to manage your symptoms in the long run.
Common NSAIDs used to treat back pain include nabumetone (Relafen), meloxicam (Mobic), diclofenac (Voltaren), and celecoxib (Celebrex).
Muscle Relaxants: Muscle relaxants may be used to treat severe acute back pain that otherwise would not respond to less powerful analgesics such as NSAIDs or Tylenol. These medications may be helpful in relieving back spasms, which are painful prolonged muscle contractions that don't up. Some of the most commonly used muscle relaxants include Carisoprodol (Soma), Baclofen (Lioresal), Tizanidine (Zanaflex), and Cyclobenzaprine (Flexeril).
Muscle relaxants have an overall sedative effect on the body, which relaxes the muscles to the point where patients aren't as affected by muscle strains and ligament strains.
Opioids: Opioids are also known as narcotic medications. Narcotic medications have an overall sedative effect on the immune system. The bind to receptors in the brain and nerve cells to alleviate pain. All of the medications under this umbrella have the same basic effects on the brain, nerves, and body, though some are stronger than others. Tramadol, for example, is one of the mildest narcotic medications on the market. Hydrocodone with acetaminophen is a more powerful narcotic, while oxycodone and Morphine are among the most powerful of the opioids that are sometimes prescribed to treat severe back pain. The more powerful the narcotic is, the greater the susceptibility patients will have to developing issues such as dependence and addiction.