Nonsteroidal Anti-inflammatory Drugs (NSAIDs) are the most commonly used type
of medication for back pain. They work by blocking a substance called prostaglandin.
Normally, prostaglandins dilate blood vessels (leading to increased blood flow)
and promote inflammation, both of which can contribute to pain. By stopping
the usual actions of prostaglandins, NSAIDs help reduce pain and inflammation.
Types of NSAIDs
NSAIDs are available over-the-counter or by prescription. They are either
seletive or non-selective. The prescription versions are generally stronger
and last longer.
Non-selective NSAIDs include:
- Diclofenac (Voltaren)
- Etodolac (Lodine)
- Ibuprofen (Advil, Motrin, Motrin IB, Nuprin)
- Indomethacin (Indocin)
- Ketoprofen (Orudis, Oruvail)
- Ketorolac (Toradol)
- Nabumetone (Relafan)
- Naproxen (Aleve, Anaprox, Naprosyn)
- Piroxicam (Feldene)
- Salsalate (Disalcid)
- Sulindac (Clinoril)
- Tolemetin (Tolectin)
Selective NSAIDs include:
Risk of ulcers and GI bleeding
Regular use of non-selective NSAIDs, especially long-term use, can have serious
complications like ulcers and bleeding from your gastrointestinal (GI) tract.
(Selective COX-2 inhibitors, however, are associated with a lower risk of ulcers
and gastrointestinal bleeding.) You are at particular risk of developing ulcers
from these drugs (including bleeding ulcers) if you:
- Are over age 60
- Have had an ulcer in the past or history of bleeding from your GI tract
- Drink alcohol on a regular basis
- Take certain medications, such as warfarin (Coumadin), steroids, or alendronate
Other possible side effects
NSAIDs can cause or worsen the following conditions:
- Cardiovascular: Evidence from large research trials has showed increased
rates of fatal and non-fatal cardiovascular events and heart attacks in patients
- High blood pressure: NSAIDs can increase blood pressure. If you
have high blood pressure, check with your doctor before using NSAIDs, especially
if you take blood pressure lowering medication.
- Kidney disease: NSAIDs can cause kidney damage. If you already have
any type of kidney disease, don't use NSAIDs. If while taking an NSAID, you
develop sudden weight gain or fluid retention (for example, you notice swelling
in your legs), notify your doctor right away.
- Diabetes: NSAIDs can cause a change in blood sugar. Check with your
doctor before using NSAIDs if you have diabetes. You may still be able to
use them, but you may need to follow your blood sugars closely and, with
the help of your doctor, adjust your diabetes medications appropriately.
Finally, NSAIDs can cause:
- Tinnitus (ringing in your ear)
- Skin rash
Review Date: 4/6/2007
Reviewed By: Benjamin D. Roye, M.D., M.P.H., Orthopaedic Surgery, The Mount Sinai Hospital, New York, NY. Review provided by VeriMed Healthcare Network.
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