There are a variety of options for medications. Together, you and your doctor
will figure out what will work best.
It is best to start with the mildest medications available. Your doctor will
likely tell you to try acetaminophen (Tylenol), aspirin, ibuprofen (Advil,
Motrin), or naproxen (Aleve) initially. You don't need a prescription for these
drugs. Many people tolerate them well for a short period of time. There are
a few reasons, however, when you should not take these medicines:
- If you have a history of bleeding from your stomach, an ulcer, or inflammation
of your stomach or elsewhere along your digestive tract.
- If you drink alcohol regularly or have a history of a liver disorder.
Prescription pain relievers
If over-the-counter medications are not enough for the pain, your doctor may
consider prescription pain relievers. These include:
- Non-steroidal anti-inflammatory drugs (NSAIDs) -- Over-the-counter
ibuprofen is an NSAID. Prescription versions can be stronger and longer acting.
Drugs in this class include diclofenac (Voltaren), etodolac (Lodine), indomethacin
(Indocin), ketoprofen (Orudis, Oruvail), nabumetone (Relafan), naproxen (Anaprox,
Naprosyn), piroxicam (Feldene), salsalate (Disalcid), sulindac (Clinoril),
Ketorolac (Toradol) and tolmetin (Tolectin). These drugs can increase your
risk for stomach ulcers and bleeding. They may also raise your blood pressure.
- COX-2 inhibitors -- This is a selective NSAID that reduces inflammation
and pain. This medicine is safer for your stomach. The only NSAID currently
available is celecoxib (Celebrex). Serious questions have been raised about
the safety of COX-2 inhibitors. Two of these drugs were pulled from the market.
The FDA ordered the manufacturer of celecoxib to add a warning to the drug's
label indicating the drug may increase the risk for heart problems or stroke.
- Narcotics -- Drugs in this category include codeine, meperidine
(Demerol), morphine (MS Contin), oxycodone (Percocet, Percodan), and tramadol
(Ultram). These medications often cause constipation and can be addictive.
Although they relieve pain, they do not generally improve activity level.
If pain relievers alone are not enough, your doctor may consider a type of
drug called a muscle relaxant, especially if you have a lot of muscle spasm
(tension in your muscles). Examples of muscle relaxants include:
- Cyclobenzaprine (Flexeril)
- Diazepam (Valium)
- Carisoprodol (Soma)
- Methocarbamol (Robaxin)
Interestingly, muscle relaxants don't actually work at the muscles. They work
by telling your brain to relax the muscles. These medications have the potential
for abuse and addiction, particularly if they are taken for a long period of
time. Drowsiness is a common side effect.
If your back pain persists for longer than a month, your doctor may consider
injecting a steroid drug in the area of the pain. This medication reduces inflammation
and pain. The doctor may consider this if you have a trapped nerve. Sciatica
is an example of back pain with a trapped nerve. A nerve may also become trapped
if you have a herniated disk.
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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