Mild pain medications can reduce inflammation and pain when taken properly. Medications will not stop wear-and-tear, but they will help control pain.
Aspirin
Aspirin is available without a prescription, and can help relieve minor pain and back ache. The main potential side effect of aspirin is stomach problems, particularly ulcers with or without bleeding. You should not take aspirin if you are pregnant; in fact, you should not take any medication unless you have discussed the medication with your obstetrician.
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
NSAIDs are available without a prescription and include ibuprofen, acetaminophen, and naproxen. They are very effective in relieving the pain associated with muscle strain and inflammation. They block the inflammatory response in joints. However, NSAIDs can affect your kidneys, especially if you are elderly. Excessive use on NSAIDS can lead to kidney and liver problems. Do not take NSAIDS if you are pregnant.
Non-Narcotic Prescription Pain Medication
Non-narcotic pain medication, or “analgesics” (the term analgesics means “pain relievers”) treat pain at the point of injury. They are used for treating mild to moderate chronic pain. Non-narcotic analgesics that require a prescription from the doctor include NSAIDs such as, carprofen, fenoprofen, ketoprofen, and sulindac. To reduce the chance of side effects when taking non-narcotic prescription medications, do not lie down for 15 to 30 minutes after taking the medication, and when you are outside, avoid direct sunlight, and wear protective clothing and sun block. Avoid using these medications if you are pregnant, or have recurrent ulcers or liver problems.
Narcotic Pain Medications
If you have severe pain, your doctor may prescribe a narcotic pain medication such as codeine or morphine. Narcotics relieve pain by numbing the central nervous system. The strength and length of pain relief differs for each drug. Narcotics can cause side effects such as nausea, vomiting, constipation, and sedation or drowsiness. These side effects are predictable and may be prevented by taking the following steps:
- Do not take sleeping aids or antidepressants when you are taking a narcotic pain medication
- Avoid drinking alcohol
- Increase your fluid intake
- Eat a high-fiber diet
- Use a fiber laxative or stool softener to treat constipation
Remember – narcotics can be addictive if used excessively or improperly.
Muscle Relaxants
Muscle relaxants can help relieve pain from muscle spasms. However, they are not completely effective, and can cause drowsiness and depression. Muscle relaxants should typically only be taken for three or four days. Long-term use is not recommended.
Antidepressants
Back pain is a common symptom of depression. Antidepressants can relieve emotional stress that leads to symptoms of back pain. An important fact to note – the same chemical reactions in the nerve cells that trigger depression also control the pain pathways in the brain. Some antidepressant medications are believed to reduce pain by affecting this chemical reaction in the nerve cells. Some types of antidepressants also make good sleeping medications. If you are having trouble sleeping due to your back pain, your doctor may prescribe an antidepressant to help you get back to a normal sleep routine. Antidepressants can have several side effects such as, drowsiness, loss of appetite, constipation, dry mouth, and fatigue.
Epidural Steroid Injections (ESI) – Nerve Block
An ESI can be used to relieve the pain of stenosis and irritated nerve roots, as well as to decrease inflammation. Injections can also help reduce swelling from a bulging or herniated disc. The steroid injections are a combination of cortisone (a powerful anti-inflammatory medication) and a local anesthetic that are given through the back into the space between the facet joint. Epidural steroid injections are not always successful in relieving symptoms of inflammation. They are used only when other conservative treatments have failed.
