Medications for pain in the spine - Causes, symptoms and treatment. MF.
How and when to take medication for pain in the spine
There is no single drug treatment effective for all diseases associated with the spine.
Although NSAIDs and painkillers are not addictive, people may think that they are getting used to these medicines, and are averse to this dependence.
NSAIDs and inhibitors of Cox-2
NSAIDs are non-steroidal anti-inflammatory drugs, the most commonly prescribed drugs. They are prescribed for various musculo-skeletal diseases affecting the spine, including muscle injuries, the formation of disc hernias, etc. NSAIDs reduce fever, pain, swelling and blood clotting. These drugs are painkillers when taken in single doses.
In large doses for an extended period of time, they are also anti-inflammatory. Side effects include irritation of the gastric mucosa, in rare cases, stomach pain, fistulas in the intestinal wall, impaired intestinal passivity and kidney failure.
Determination of the required NSAID from pain.
The choice and dose of NSAIDs depend on the factors associated with the health status. Acute functional disorders( muscle stretching) that occur in young people require high-speed and pain-relieving NSAIDs such as ibuprofen, naproxen, ketoprofen, refecoxite. In acute functional disorders, NSAID treatment usually lasts from two to four weeks. The toxicity of the drug should not bother you if you are young. The stretching of the muscles will take place within a short period of time, and there will be no health problems.
Aspirin is a potent NSAID, reduces back pain and is an effective remedy, but potentially toxic. The same properties that make aspirin effective in preventing heart attacks and strokes, increase the possibility of bleeding. In addition to stomach ulcers, aspirin can cause ringing in the ears, reversible deafness and death, if taken in large doses. Never exceed the recommended dose without consulting your doctor.
Take an inhibitor of COCS-2 if you have a predisposition to a stomach ulcer. If you take NSAIDs daily or a COCS-2 inhibitor daily, you should regularly weigh and measure blood pressure. Some NSAIDs can promote fluid retention in the body and increase blood pressure, a blood test also shows the level of intoxication affecting the pulse, kidney and liver function.
Time of administration and dosing of
Dosage of NSAIDs and inhibitors of COCS-2 is different, depending on how long they are in the body. This is called the half-life of the drug.
If the drug stops after several hours, you can take an additional dose at the end of the day.
NSAIDs should be taken with meals to reduce gastric intoxication, and Cox-2 inhibitors should be taken only on an empty stomach. You should check the reaction of your body to various doses of these medicines, but only under the supervision of a doctor.
The study of muscle relaxants led to the conclusion that they help to relieve back pain, like NSAIDs, but cause drowsiness in 30% of people taking them, so they are prescribed infrequently.
The combination of NSAIDs and muscle relaxants effectively contributes to the cessation of the pain and spasmodic cycle, characterized by muscle pain, which causes increased muscle spasms. The analgesic and the muscle relaxant are actively involved in the cure of both components of the cycle. Treatment of one component does not solve the problem, because either pain or spasms continue. To completely free from muscle spasms, two types of medication are needed.
There are various muscle relaxants. Some medicines contain piclobenzaprine( flexeryl), orfenadrine( norflex), chlorosoxazone( paraffon forte) and metaxalone( skeleaxin).
Narcotic and non-narcotic painkillers
If you are intolerant to NSAIDs, analgesics can help you. Conventional pain relievers reduce pain, but do not have an effect on the inflammatory process, so in many cases this treatment is of little interest. Medications that relieve pain, are divided into non-narcotic and narcotic.
Acetaminophen( Tylenol) is an analgesic without anti-inflammatory effect. It reduces the production of prostaglandins in the central nervous system, but has no effect on their occurrence in other body systems. Acetaminophen is less effective than analgesic, but it does not have toxic side effects, such as stomach ulcers or breathing difficulties associated with NSAIDs. If you have intolerance to aspirin, acetaminophen should be the first release from pain. It should also be taken if you are aged and you have osteoarthritis of the spine. Take the drug in combination with NSAIDs or sleeping pills.
Tramadol( ultram) is another non-narcotic analgesic that acts as effectively as aspirin and ibuprofen. Its action is a link in the activation of the sleepy receptors and serotonin receptors in the central nervous system. Like acetaminophen, tramadol does not have the opposite action with NSAIDs.
There is no need to take narcotic painkillers for the treatment of acute back pain such as codeine, hydrocodone, meperedin morphine or fentanyl. However, if you have severe sciatica associated with disc hernias, narcotic analgesics along with NSAIDs and muscle relaxants are part of a prescribed treatment that reduces pain. The likelihood of addiction development is the main problem of drugs, so the drugs stop as soon as possible. Drug medications affect receptors that reduce pain in the central nervous system.
For the treatment of chronic back pain, a limited intake of narcotic painkillers is required. In the past, taking drugs was necessary every few hours, as their analgesic effect quickly stopped. Not so long ago, narcotic drugs with long-term action, including oxycopin, cadian, MC-kontin and durgadzhek, have been developed. These medications can be taken twice a day or in the form of a patch once every three days.
Codeine is the best drug for home use. Other drugs, such as oxycodone or hydrocodone, in various combinations with aspirin or acetaminophen are useful in reducing pain. The task is to reduce the intake of these medications as soon as the pain decreases.
Oral corticosteroids are intended for people with severe pain or muscle weakness who are not helped by NSAIDs alone. The decision to take corticosteroids should be taken after a full medical examination. Small doses for a short period of time reduce the possibility of toxic side effects.
If within a month there is no improvement, - the reception of isopentenoids ceases immediately.
In rare circumstances, small doses of prednisone may be used to treat spinal stenosis. Patients who are not affected by epidural injections who underwent the maximum course of NSAID treatment and who refused to undergo decompression surgery usually remain disabled, can not move even for short distances. Under such circumstances, the use of prednisolone in small doses may be helpful.
You should always check the reaction to medication. If there is no improvement, the drug will stop taking.
Treatment of epidural and corticosteroid injections
Oral corticosteroids are easy to take but their disadvantage is that they are systemic, that is, they have an effect on the entire body. Epidural injections are safe;complications, infections and toxicosis - rare cases. Improvement does not come immediately, it takes time for corticosteroids to reduce the tumor of the nerves. It may take a week before you notice a reduction in leg pain, but the improvement lasts for months. Epidural injections should be taken into account if your body does not respond to medication treatment, and you do not want to undergo surgery on the spine.
Iontophoresis;another type of treatment with "injections"
Iontophoresis is an apparatus that uses a direct current from a 9-volt battery to transfer the drug to the body surface without injection. Local anesthesia and soluble corticosteroids are the drugs most commonly used by iontophoresis. The drug is injected into a soft pad that is placed above the painful area. Treatment lasts about 20 min. The frequency of procedures helps to reduce pain. Procedures can not be repeated too often due to the constituents of corticosteroids. They should be administered intermittently, but for an extended period of time. Sometimes iontophoresis promotes local anesthesia, having a significant effect on overall functioning.
Treatment with anti-inflammatory drugs reduces pain and inflammation and helps maintain performance.
Muscle relaxants reduce muscle spasms when taken with NSAIDs.
Painkillers, both narcotic and non-narcotic, relieve pain, but do not reduce inflammation.
The useful maximum effect of drug treatment is achieved by trial and error. You may need to try several different types of medication to find one that alleviates pain and has the least side effects.
Injections of corticosteroids into the spine help with secondary sciatica from a herniated disc. Isopenty can be applied through the skin without injections due to the constant current from the battery( iontophoresis).