Find The Right Medications For You And Use Them Correctly
Just about everyone gets back pain. In fact, an estimated 80% of people will seek medical attention for back pain at some point in their lives. Most of the time, popping a few over-the-counter pain relievers does the trick. But are drugs the best way to combat regular flare-ups?
“Medication can be a crucial part of managing and treating occasional and recurring pain, and can help you stay pain-free and active, but you have to use the right ones for you, and in the right way,” says Dr. Robert Shmerling, former clinical chief of rheumatology at Harvard-affiliated Beth Israel Deaconess Medical Center.
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The Best Muscle Relaxants
There is some evidence that Cyclobenzaprine , Carisoprodol , Methocarbamol , and Tizanidine work better than the other muscle relaxants.
According to one study:
- There is fair evidence that cyclobenzaprine, carisoprodol, orphenadrine, and tizanidine are effective compared to placebo in patients with musculoskeletal conditions .
What Are Your Options
If you try acetaminophen for a backache and it doesn’t work as well as you need it to, then stop taking it, says Dr. Katz. “Three to five days is all you need to find out if it will work.”
Also, you don’t necessarily have to choose between acetaminophen and NSAIDs you could try both at the same time. “They are often used in combination, because they don’t appear to have additive side effects, while many people find that they have additive benefits,” Dr. Katz says.
Finally, remember that pain relievers are just one tool available to men with back pain, whether occasional or chronic. Make sure to do all the other things mentioned above to recover from or prevent future flare-ups.
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Best Topical Back Pain Option: Diclofenac Gel
How it works
Topical diclofenac is a back pain gel that you can apply right where you feel the pain. As an NSAID, it works by decreasing inflammation like those that you take by mouth. Since you put it right where you feel the pain, it focuses on that area and has fewer effects in other places.
Dosage
Its best to use the smallest amount possible that helps the pain. Each product should include a dosing card and instructions to help you measure how much gel to use.
Precautions and side effects
Topical NSAIDs are usually less likely to cause kidney damage and stomach ulcers than tablets. But they can irritate the skin.
Costs
Until recently, topical diclofenac was only available with a prescription. Unfortunately, that prescription could be expensive. OTC prices for Voltaren gel start at around $10.
Prescription strength available?
The OTC strength is similar to the prescription strength.
Best For All Day/night Back Pain Relief: Naproxen
How it works
Naproxen is another NSAID. It works by decreasing inflammation, similar to ibuprofen. But it lasts longer than ibuprofen.
Dosage
Naproxen is available OTC as a 220 mg tablet. A typical OTC dosing is 220 mg every 8 to 12 hours. The maximum OTC dosage is 3 tablets in 24 hours.
Precautions and side effects
These are the same as with ibuprofen. Watch out for kidney disease, dehydration, and stomach ulcers. And you should also check with your healthcare provider first if youve had a heart attack or if you have heart failure.
Costs
Naproxen is also inexpensive. A months supply is a few dollars. Some of the brand-name formulations can be more expensive.
Prescription strength available?
Yes, prescription strength is available. These are the high-dose tabs . Naproxen is also available in 375 mg and 500 mg delayed-release tabs as well as extended-release tablets, ranging from 375 mg to 750 mg.
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Prescription Nsaids For Back Pain Relief
There are prescription-only NSAIDs for back pain relief. Some common ones are meloxicam, celecoxib, and indomethacin. There are different reasons that your healthcare provider may recommend these instead of OTC NSAIDs. Common reasons include side effects from OTC NSAIDs and interactions with other medications. These can be a good option if you need to take NSAIDs longer term.
What Is The Best Medication For Lower Back Pain
| Best medications for lower back pain | |
|---|---|
| Drug name | |
| 50 mg taken as needed every 4 to 6 hours | Sleepiness, uncontrollable shaking, and mood swings |
Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
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The Best Muscle Relaxants For Back Pain
Muscle relaxants should only be used if NSAIDs are not enough for your back pain.
You should only take a muscle relaxant for about one to two weeks since they have side effects and have not been studied for long-term use.
Also do not take muscle relaxants with alcohol, opioid pain medications, or anti-anxiety drugs that make you sleepy . Combining these drugs with muscle relaxants can make your breathing more difficult.
The best muscle relaxant for back pain is Cyclobenzaprine since it has the most evidence. It does cause sleepiness, however, so do not use it while working, driving, or if you are at risk of falls .
A close second is Methocarbamol , which I have personally used, since this drug does not cause sleepiness. It may be more expensive though.
Traction Ultrasound And Tens
If your back pain doesnt respond to conventional treatments, you may need to consider alternative options.
Traction uses a system of weights to align your spine and possibly help slipped discs move back into place.
Ultrasound involves massaging the soft tissues around your back injury with sound waves that warm the muscles, causing them to relax and heal more quickly.
Transcutaneous electrical nerve stimulation is electronic stimulation of the nerves through electrodes placed on your skin.
The electricity blocks pain signals that travel through the nerve paths.
Ask your doctor about these treatment methods.
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What Causes Back Pain
Most lower back pain is nonspecific lower back pain so called because it’s not clear what’s actually causing the pain. Sciatica is another type of lower back pain, caused by irritation or pressure on a spinal nerve, with pain being felt along the course of the nerve, perhaps as far as the legs and feet. Rarer forms of back problems are bone disorders, tumours and infections.There are myriad causes of back pain, from injury, postural issues and diseases such as osteoarthritis and osteoporosis, to lifestyle factors such as physical fitness, smoking, being overweight and occupation. Age and genetics also play a role.Lower back pain usually clears up within six weeks, whether treated or not. However, up to 30% of people suffer ongoing symptoms or repeat episodes of pain. Acute lower back pain lasts a few days to a few weeks, while pain that lasts for more than three months is considered chronic.
What Is The Source Of This Information
This information comes from a research report that was funded by the Agency for Healthcare Research and Quality, a Federal Government agency.
Researchers looked at 156 research studies on noninvasive treatments for low back pain. The studies were published before April 2015. Health care professionals, researchers, experts, and the public gave feedback on the report before it was published.
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Cyclobenzaprine Effectiveness For Back Pain
Cyclobenzaprine is a great first choice for a muscle relaxant for back pain. According to the same study:
- Cyclobenzaprine has been evaluated in the most clinical trials and has consistently been found to be effective.
Cyclobenzaprine has more evidence than other muscle relaxants for relieving muscle pain.
For more information on cyclobenzaprine, click here.
Is This Information Right For Me
This information is right for you if:
- You have low back pain
- Your low back pain is not caused by:
- Injury or pressure on the nerve roots in the spine
- A high-speed injury
- Pregnancy
- Cancer, an infection, problems with your nervous system, a broken bone, or certain types of arthritis
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What Can I Do To Relieve My Lower Back Pain
There are many options for relieving lower back pain depending on the cause, severity, and duration of the pain. For some patients medications or treatments such as transcutaneous electrical nerve stimulation and epidural steroid injections can help. Others see specialists like chiropractors, physical therapists, or pain management physicians. Each patients needs are different. A great first step is seeing your primary care provider.
Lower Back Pain Treatment Options
, according to the National Institute of Neurological Disorders and Stroke . Discomfort in the lower back can be chronic or ongoing. It can also be a sudden and brief condition known as acute pain.
Causes of lower back pain include:
- spinal abnormalities, such as a slipped disc or spinal stenosis
Treatment options for lower back pain range widely according to the cause of the condition. Read on to learn more.
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Remedies Less Likely To Help
Cleveland Clinic spine specialists generally do not support the use of passive treatments for low back pain.
Chronic use of low-level laser therapy, ultrasound, transcutaneous electrical nerve stimulation and spinal manipulation may only help in the short term, Dr. Mayer points out. We dont want you to waste your money on treatments unlikely to provide more than a day of benefit.
Common Causes Of Chronic Back Pain
Chronic back painis usually age-related, but can also result from a prior injury. The mostcommon causes include:
- Arthritis of the spine the gradual thinning of the cartilage inside the spine
- Spinal stenosis narrowing of the spinal canal that may lead to nerve pain
- Disc problems, such as a herniated or bulging disc
- Myofascial pain syndromeunexplained muscle pain and tenderness
In some cases, its difficult to pinpoint the cause of chronic back pain.If your doctor has exhausted all diagnostic options, its time to seek asecond opinion from a back pain specialist, recommends Nava. Itsimportant not to make rushed decisions or undergo extensive medicalprocedures until the origin of the pain is found. Not only may they nothelp they could make the pain worse, warns Nava.
If the source of the pain is not known or cant be treated, your bestoption may be to work with your doctor on reducing the flare-ups and makingthe pain manageable with nonsurgical treatments.
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Why Experts Recommend It
Tylenol is a good alternative for those who have any underlying conditions in which a nonsteroidal anti-inflammatory drug would not be appropriate. It is an effective pain reliever with fewer side effects than NSAIDS.
There are also stronger formulations, such as extra-strength Tylenol specifically designed for arthritis relief. The high-dose form has a greater risk of side effects and serious complications.
What Medications Can Be Used To Get Pain Relief From Low Back Pain
There are various types of medications that can be used to treat back pain. Some of them are available over the counter, while others are prescription medications. Here is a brief overview of the medications that can be effective against lower back pain.
Acetaminophen
This is usually the first line of treatment for lower back pain. Acetaminophen relieves minor aches and pains. However, this medicine is not an anti-inflammatory drug, meaning it does not reduce swelling and inflammation. Therefore, it may or may not be effective, even for minor back discomfort. The advantage, however, is that acetaminophen is gentler on the stomach compared to NSAIDs and is less likely to cause stomach bleeding.
Keep in mind that acetaminophen can damage the liver at high doses. According to the U.S. Food and Drug Administration , you should not take more than 4,000 mg of acetaminophen in one day. Doctors often advise a maximum daily dose of 3,000 mg. Generally, it is highly recommended that one should not take more than that 3,000 mg limit of acetaminophen, especially if it is consumed on a regular basis. Keep in mind that Extra Strength Tylenol has more acetaminophen than regular strength Tylenol .
Non-steroidal anti-inflammatory drugs
These drugs are a group of pain relievers that are available over-the-counter or with a prescription. They help to reduce pain, swelling, and fever. NSAIDs can treat back pain in most cases when it is mild to moderate.
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What Are Common Side Effects Of Lower Back Pain Medication
Since lower back pain sufferers are looking for pain relief, the medications used to treat this condition will generally have the same or similar side effects. While these side effects tend to be similar they are not always the same for everyone and their severity will vary. This is not a complete list and you should always consult your doctor regarding your potential risks when starting a new medication. Potential side effects of lower back pain medication can include:
- Drowsiness
- Headache
Related Resources For Lower Back Pain
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This article is not medical advice. It is intended for general informational purposes and is not meant to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, immediately call your physician or dial 911.
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Pain Relief For Lower Back Pain
If you have low back pain, your GP may suggest you take an over-the-counter NSAID such as ibuprofen. If this doesnt help, your doctor may prescribe a different NSAID or another type of painkiller that may work better for you. They will prescribe the lowest dose to take for the shortest period of time. NSAIDs can cause stomach problems such as indigestion, which causes pain and discomfort, bloating and nausea. NSAIDs can also cause stomach ulcers and bleeding. So, your doctor may also prescribe another medicine to protect your stomach while youre taking the NSAID.
You could try an NSAID cream or gel and apply it to the affected area. The advantage of using a cream is that its far less likely to cause any stomach problems. But creams and gels only work where you apply them. For example, although an ibuprofen tablet might help pain in both your back and knee, you would need to apply a cream to both places.
If youre not able to take an NSAID, your doctor may prescribe a medicine called an opioid . You might have this with or without paracetamol. Paracetamol isnt thought to help much when used alone for treating lower back pain. But it works well when combined with other medications.
Theres a risk of becoming dependant on codeine, and it can also cause constipation. Your doctor will take this into consideration and explain the risks and side-effects to you.
Get Active To Treat Chronic Lower Back Pain
lasts 12 weeks or moreNow we know bed rest is one of the worst things to do to treat back pain.make the pain worse
If the pain persists, we recommend scheduling an evaluation from a physical therapist. A physical therapist can teach you how to do special exercises to stretch and strengthen the spine, which should help relieve the pain.
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Heat And Ice For Back Pain
A hot water bottle or heat pad may help ease muscle spasm and pain. Make sure your skin is protected dont put heat pads directly on your skin. You can buy pads that you put over your clothing on the area that hurts. These are available from pharmacies and last for several hours.
Ice packs may also be helpful, especially in the first few days of any injury. Make sure you wrap the ice pack in a towel to protect your skin. You can apply the pack to the area that hurts for 15 minutes at a time.
What Are The Best Home Remedies For Lower Back Pain
Depending on the severity and cause, you may be able to reduce or eliminate your lower back pain at home. Many of these remedies are short-term solutions, but can help you avoid medications while you wait for your next doctors appointment. After consulting a healthcare professional, you may be able to rely on these solutions entirely for minor pain.
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How Can I Relieve Back Pain At Home
You can manage back pain at home with over-the-counter medications, natural remedies, or very light exercise techniques. Medications such as ibuprofen, naproxen, acetaminophen, or aspirin can alleviate pain. Natural remedies like turmeric or ice can reduce inflammation. Or, you can try stretching, walking, or other light exercise. However, you should consult a doctor before starting new physical activity to avoid injuring yourself further.
What Questions Should I Ask My Healthcare Provider About Back Spasms
- Whats the best treatment for me?
- Do my back spasms mean that I have a serious disorder?
- Should I see a therapist for help with my stress?
- Should I try a muscle relaxant?
A note from Cleveland Clinic
Remember that its important to stay active even when youre in pain ! Get up and stretch every 30 minutes and exercise three times a week. To help with your pain, take over-the-counter medications and muscle relaxants and get a massage. Always discuss your symptoms with your healthcare provider so that you can get the best care.
Keep in mind that back spasms are sometimes a symptom of a serious disorder. Notice other symptoms you might have alongside them and go to the emergency department if you have tingling/numbness on one side, weakness or if you lose your ability to control your bowel or bladder. If youre debating whether or not to go to the emergency department, its better to go and be told youre not in serious condition than to stay home.
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