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Spinecare Topics
Treatment with Medications
Pharmaceutical Treatment for Back Pain
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Pharmaceutical Treatment for Back Pain
Anti-Depressants and Muscle Relaxants
Tricyclic anti-depressants, such as amatriptaline (Elavil and Nortriptyline [Pamelor]) may be used to treat chronic low back or neck pain. Anti-depressants are used to help block (inhibit) the pain cycle and to reduce the perception of pain. Anti-depressant drugs are often used at a dose that is much less than that used to treat depression. Individuals with chronic pain and clinical depression may respond favorably to larger doses of the right anti-depressant(s). One of the most common side effects of anti-depressant is drowsiness. This can be a beneficial side effect if it occurs at night to help an individual with low back pain obtain more restorative sleep.
Muscle Relaxants
Muscle relaxants are used in an attempt to reduce the pain associated with muscle spasm. A muscle may be in spasm due to direct injury secondary to persistent reflexive muscle guarding. Muscle relaxants may be utilized with NSAIDs in order to reduce the intensity and duration of muscle spasms while reducing inflammation, both in an attempt to reduce pain and improve function. Commonly used muscle relaxants include cyclobenzaprine (Flexeril), carisoprodol (Soma) and orphenadrine (Norflex). The most of the more common side effects associated with the use of muscle relaxants is drowsiness and muscle fatigue.
Central Nervous System-Modifying Drugs
Gabapentin (Neurontin) is a medication that has been shown to help reduce the pain associated with neurological compromise. This pharmaceutical approach may be helpful in the treatment of patients with radiating pain and numbness secondary to nerve root compromise (radiculopathy). One of the more common side effects associated with Neurontin is drowsiness. The medication Dizanidine (Zanaflex) also works on the central nervous system to relax muscles. For some it helps reduce pain associated muscular involvement. The reduction of muscle spasms helps to increase flexibility, functionality and improve the level of participation in a rehabilitative program.
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
Disease-modifying anti-rheumatic drugs (DMRDs) is a class of medications that physicians may utilize for the treatment of ankylosing spondylitis, as well as other forms of inflammatory arthritis that may afflict the back. The most common progressive form of inflammatory arthritis is rheumatoid arthritis. DMRDs are used in an attempt to modify the course of the inflammatory process and in some cases, slow or even halt the progression of the arthritis and associated pain. These drugs work by suppressing the immune system, which is actively involved in joint tissue compromise. These types of drugs can take many weeks to work. Pharmaceutical examples of DMRDs include Methotrexate, Leflunomide (Arava), Hydroxychloroquine Sulfate (Plaquenil) and Sulfasalazine (Azulfidine).
Opiod Pain Relievers
Opiods refer to morphine–like drugs. Opiods can offer effective treatment of pain and related suffering. They tend to be more effective for acute than chronic pain. The most common side effects are sedation, constipation and nausea. Opiods are not the first line approach for pain due to the risks associated with addiction. Opiods work by chemically blocking pain signals that travel along nerves. They activate specialized chemical doors on nerve cell membranes called opiod receptors which when activated block a nerve’s ability to transmit or carry a pain signal to the brain. Some opiods work by reducing the central nervous systems ability to remove neurotransmitters such as serotonin and norepinephrine, which results in blocking of pain signal transmission.
Tricyclic anti-depressants, such as amatriptaline (Elavil and Nortriptyline [Pamelor]) may be used to treat chronic low back or neck pain. Anti-depressants are used to help block (inhibit) the pain cycle and to reduce the perception of pain. Anti-depressant drugs are often used at a dose that is much less than that used to treat depression. Individuals with chronic pain and clinical depression may respond favorably to larger doses of the right anti-depressant(s). One of the most common side effects of anti-depressant is drowsiness. This can be a beneficial side effect if it occurs at night to help an individual with low back pain obtain more restorative sleep.
Muscle Relaxants
Muscle relaxants are used in an attempt to reduce the pain associated with muscle spasm. A muscle may be in spasm due to direct injury secondary to persistent reflexive muscle guarding. Muscle relaxants may be utilized with NSAIDs in order to reduce the intensity and duration of muscle spasms while reducing inflammation, both in an attempt to reduce pain and improve function. Commonly used muscle relaxants include cyclobenzaprine (Flexeril), carisoprodol (Soma) and orphenadrine (Norflex). The most of the more common side effects associated with the use of muscle relaxants is drowsiness and muscle fatigue.
Central Nervous System-Modifying Drugs
Gabapentin (Neurontin) is a medication that has been shown to help reduce the pain associated with neurological compromise. This pharmaceutical approach may be helpful in the treatment of patients with radiating pain and numbness secondary to nerve root compromise (radiculopathy). One of the more common side effects associated with Neurontin is drowsiness. The medication Dizanidine (Zanaflex) also works on the central nervous system to relax muscles. For some it helps reduce pain associated muscular involvement. The reduction of muscle spasms helps to increase flexibility, functionality and improve the level of participation in a rehabilitative program.
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
Disease-modifying anti-rheumatic drugs (DMRDs) is a class of medications that physicians may utilize for the treatment of ankylosing spondylitis, as well as other forms of inflammatory arthritis that may afflict the back. The most common progressive form of inflammatory arthritis is rheumatoid arthritis. DMRDs are used in an attempt to modify the course of the inflammatory process and in some cases, slow or even halt the progression of the arthritis and associated pain. These drugs work by suppressing the immune system, which is actively involved in joint tissue compromise. These types of drugs can take many weeks to work. Pharmaceutical examples of DMRDs include Methotrexate, Leflunomide (Arava), Hydroxychloroquine Sulfate (Plaquenil) and Sulfasalazine (Azulfidine).
Opiod Pain Relievers
Opiods refer to morphine–like drugs. Opiods can offer effective treatment of pain and related suffering. They tend to be more effective for acute than chronic pain. The most common side effects are sedation, constipation and nausea. Opiods are not the first line approach for pain due to the risks associated with addiction. Opiods work by chemically blocking pain signals that travel along nerves. They activate specialized chemical doors on nerve cell membranes called opiod receptors which when activated block a nerve’s ability to transmit or carry a pain signal to the brain. Some opiods work by reducing the central nervous systems ability to remove neurotransmitters such as serotonin and norepinephrine, which results in blocking of pain signal transmission.
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