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eLearning Series:
Relieve My Back Pain NOW!
( 23 pages )
BACK
PAIN: MEDICATIONS
Among the common
pain relief medications prescribed by physicians are muscle
relaxants, antidepressants, NSAIDs (nonsteroidal
inflammatory drugs) and COX –2 inhibitors. Some popular muscle
relaxants are cyclobenzaprine (Flexeril), carisoprodol (Soma),
methocarbamol (Robaxin) and gabapentin, in seizure medications.
The NSAIDs help with stiffness and in reducing inflammation.
Opiates like Duragesic or OxyContin may be prescribed but are
not a popular choice with a low risk of possible addiction.
With all medications,
other treatment strategies should be combined into the relief
program. So physical therapy, movement
and posture techniques and other treatment options should
be carefully assessed to see which combination best helps
relief
over time.
Doctors may also
prescribe injections, such as Sacroiliac joint blocks, Thoracic
Facet Joint injections,
Epidural steroid
injections,
selective nerve root block, and Facet rhizotomy.
Muscle
relaxants act on the brain, not on the muscle. They help
relieve pain so that patients are able to exercise
and have other physical treatments that would otherwise
be too
painful. Muscle relaxants are sedatives, so doctors may
prescribe them to be taken at night to avoid daytime
drowsiness. They
should not be taken when driving or operating heavy machinery.
Muscle relaxants have been shown to be effective alone
or in conjunction with anti-inflammatory medications
within a week
of the onset of severe muscle spasm in the lower back.
Side
effects include drowsiness, dizziness, addiction after
one week of use, dry mouth and urinary retention. Some
common
muscle relaxants are carisoprodol (Soma), cyclobenzaprine
(Flexeril),
diazepam (Valium), metaxalone (Skelaxin), methocarbamol
(Robaxin).
Low doses of tricyclic
antidepressants have been used to relieve chronic back pain.
They work by increasing
the
level of certain
chemicals in the brain that change the way the brain
perceives pain. They are not used for sudden and acute
pain, and
usually take two to three weeks to go into effect.
Side effects include
constipation, dry mouth, blurred vision, drowsiness,
fatigue, low blood pressure, weight gain, increased
appetite, sweating,
and urinary retention. Since side effects vary from
medication to medication, it is worth trying another antidepressant
if one does not work well. Some common antidepressants
used to
treat back pain are amitriptyline (Amitril, Elavil,
Endep),
doxepin hydrochloride (Sinequan), imipramine hydrochloride
(Janimine, Tofranil), nortriptyline (Pamelor), and
desipramine (Norpramin).
NSAIDS and COX-2
inhibitors are effective in relieving pain and reducing inflammation.
They
are generally
the first line
of treatment in acute low back pain. NSAIDS are usually
taken for one to three weeks but can be taken for
four weeks or
longer. People under the age of twenty should not
take NSAIDS because
they can cause Reye’s syndrome, a central nervous
system disorder. Other people who should not take NSAIDS
include
those taking
blood thinners, corticosteroids, lithium, and oral
antidiabetic medication. Before taking NSAIDS you
should let your
doctor know if you are pregnant, trying to get pregnant,
breastfeeding,
or have a peptic ulcer, history of gastrointestinal
bleeding, nasal polyps, kidney or liver disease,
allergic reactions
to aspirin or related drugs, anemia, or a blood-clotting
defect.
Short-term side effects can include stomach irritation,
which can be minimized by taking them with food and
a full glass
of water. Taking NSAIDS long term can cause ulcers.
In rare cases, naproxen, ibuprofin and rofecoxib
have caused
meningitis.
A common nonprescription NSAID is aspirin (Anacin,
Bayer, Bufferin). A common prescription NSAID is
naproxin (Naprosyn).
Some common
COX-2 inhibitors are celecoxib (Celebrex), rofecoxib
(Vioxx), and valdecoxib (Bextra).
COX-2 inhibitors
are less likely to cause stomach problems, but
they may increase the risk of heart
attack. If
you have a history of heart trouble, talk to your
doctor to see if
COX-2 inhibitors are best to treat your back pain.
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