Aspirin
Aspirin compounds are over-the-counter medications that can help
relieve minor pain and back ache. The main potential side effect with
aspirin is the development of stomach problems- particularly ulcers
with or without bleeding.
NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs) include
over-the-counter pain relievers such as ibuprofen and naproxen. These
medications were once only available by prescription. NSAIDs are very
effective in relieving the pain associated with muscle strain and
inflammation. Be aware that NSAIDs can decrease renal function if you
are an older patient. Excessive use can lead to kidney problems.
COX-2 Inhibitors
A new class of NSAIDs is gaining wide acceptance in its ability to
reduce inflammation. Commonly called COX-2 inhibitors, these newer
NSAIDS work by selectively blocking the formation of pain-causing
inflammatory chemicals. COX-2 inhibitors appear to be easier on the
stomach, mainly because they don't interrupt stomach enzymes like
traditional NSAIDs. Celecoxib (Celebrex(r)) and refecoxib (Vioxx(r))
are two commonly prescribed COX-2 inhibitors.
Nonnarcotic Prescription Pain Medications
Nonnarcotic analgesics (pain relievers) are ideal in the treatment
of mild to moderate chronic pain. Tylenol(tm) and aspirin are the most
widely used over-the-counter analgesics. Medications that are
analgesics and require a prescription from the doctor include NSAIDs,
such as carprofen, fenoprofen, ketoprofen, and sulindac. To reduce side
effects do not lie down for 15 to 30 minutes after taking the
medication, avoid direct sunlight, and wear protective clothing and sun
block. Avoid using these medications if you have recurrent ulcers or
liver problems.
Narcotic Pain Medications
If you experience severe pain, your doctor might prescribe a
narcotic pain medication such as codeine or morphine. Narcotics relieve
pain by acting as a numbing anesthetic to the central nervous system.
The strength and length of pain relief differs for each drug.
Narcotics can have side effects such as nausea, vomiting,
constipation, and sedation (drowsiness). These side effects are
predictable and can often be prevented. Common preventive measures
include not taking sleeping aids or anti-depressants along with
narcotics, avoiding alcohol, increasing fluid intake, eating a high
fiber diet, and using a fiber laxative or stool softener to treat
constipation. Remember that narcotics can be addictive if used
excessively or improperly.
Muscle Relaxants
If you are having muscle spasms, muscle relaxants may help relieve
pain. They have only been shown to be marginally effective. Muscle
relaxants also have a significant risk of drowsiness and depression.
Long-term use is not suggested; only three to four days is typically
recommended.
Anti-depressants
Back pain is a common symptom of depression and could be an
indicator of its presence. Similarly back pain can lead to emotional
distress and depression. It seems that the same chemical reactions in
the nerve cells that trigger depression also control the pain pathways
in the brain. Anti-depressants can relieve emotional stress associated
with back pain. Some anti-depressant medications seem to reduce
pain-probably because they affect this chemical reaction in the nerve
cells.
Some types of anti-depressants make good sleeping medications. If you are having
trouble sleeping due to your back pain, your doctor may prescribe an anti-depressant
to help you get back to a normal sleep routine. Anti-depressants can have
side effects such as drowsiness, loss of appetite, constipation, dry mouth,
and fatigue.
