Roughly 25% of Americans have endured lower back pain in the past three months. Back pain is one of the most common forms of disability among those under the age of 45. Over the course of their life, nearly 80% of people will seek treatment for some type of back pain. Over-the-counter pain relievers are products that are often sufficient to minimize back pain. Dr. Robert Shmerling, chief of clinical rheumatology with the Harvard-affiliated Deaconess Medical Center, explained that medications are generally effective. He stresses that it is critical to “use the right ones…in the right way.”
Sources of Back Pain
Many people with back pain are older men with weakened “core muscles” and reduced muscle mass. Other common sources include osteoarthritis, injuries, and depression. Back pain that is persistent should be examined by a doctor, particularly when accompanied by related conditions such as weakened legs. Medications are used to treat the symptoms; however, they do not treat the medical condition(s) that are the true source.
Acute vs Chronic Back Pain
Acute pain in the lower back area is that which last for up to roughly six weeks. The severity of the pain may range from mild to very significant. Chronic back pain is that which is persistent for a long period. It is likely to occur from repetitive work or sports injuries and be related to arthritis.
OTC Pain Relief
There are many OTC pain relievers that can reduce fever, feelings of stiffness, and muscle soreness. Acetaminophen (Tylenol) functions to alter the way the brain interprets feelings of pain. Other nonsteroidal anti-inflammatory drugs (NSAIDs) are also available including naproxen (Aleve) and ibuprofen (Advil and Motrin). These oral medications also minimize swelling and inflammation that is related to the pain.
Pain and inflammation are closely linked. Inflammation may be a cause or may potentially worsen back pain. In addition to the OTC NSAID products, there are stronger options available by prescription. Examples of these include celecoxib (Celebrex) and meloxicam (Mobic). Anti-inflammatory products may also be administered in the form of a topical cream such as diclofenac (Voltaren).
Prescription muscle relaxers reduce pain by suppressing the central nervous system. Some of the commonly used products include:
- Cyclobenzaprine (Flexeril): Is effective in treating muscle spasms for a short period of up to two or three weeks. The drug may be used in conjunction with physical therapy.
- Tizanidine (Zanaflex): A prescription product that may effectively treat tightness, spasms, and cramping. Those with spinal problems or multiple sclerosis may experience some short-term relief.
- Baclofen (Lioresal): Many suffering from back pain may find this product to be effective. It is typically taken three times per day and the dosage is often slowly increased.
- Carisoprodol (Soma): Carisoprodol is commonly used as a skeletal muscle relaxer. There are an estimated three million people in the U.S. who are prescribed the drug.
Muscle relaxants are to be used with caution due to their potential for creating drowsiness. Many of those treated will recognize improved flexibility and function in as little as a few days.
Those who are experiencing more severe back pain may be prescribed opiates. These drugs work by engaging the receptors in the brain to reduce pain. One milder such prescription product available is tramadol (Ultram). Stronger opioids include oxycodone (OxyContin) and a combination of acetaminophen and hydrocodone (Vicodin). They are quite effective in most cases; however, they often generate a feeling of euphoria and are now considered highly addictive.
Those who do not benefit from other forms of pain relief may undergo an injection of cortisone, an anti-inflammatory product. It may be injected in the region of the spinal cord and combined with a local anesthetic. Corticosteroid injections may work to relieve pain associated with inflamed nerves. Steroids are among the most powerful ways of reducing inflammation. Due to potential side effects, these treatments are generally limited to a few per year.
Some patients may experience pain relief from low doses of certain antidepressants, such as tricyclic forms including amitriptyline (Elavil).
The results are largely attributed to the medication’s ability to interact with chemicals in the brain. In addition to back pain, they have been used to treat migraine headaches and menstrual pain.
Anticonvulsants, such as gabapentin, are most commonly used for those with seizure disorders. In some patients, they have also been successful in treating lower back pain. This form of treatment is believed to be the result of the medication’s ability to interact with nerves. A recent study in Australia has found their overall effectiveness in treating back pain as still somewhat questionable.
Combinations of Treatment
Various types of pain medication and means of administration have proven effective in the treatment of back pain. Often your medical provider will combine treatment by medication with other forms of physical treatment. Examples may include massage therapy, physical therapy, and yoga.
Back Pain Specialists in Maricopa and Pinal County
The Arizona Pain and Spine Institute is an established provider of pain management solutions. How are we able to successfully treat pain that is associated with such a vast number of conditions? We work with a comprehensive team of practitioners including those specializing in orthopedics, neurosurgery, physical and occupational therapy, and many others. This wealth of clinical expertise is combined with the best in today’s evolving advancements in research and technology. Contact us today at (480) 986-7246 for an appointment at one of our office locations.