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YOU are here : Home > Spinecare Topics > Treatment with Medications > Pharmaceutical Treatment for Back Pain
Spinecare Topics
Treatment with Medications
Pharmaceutical Treatment for Back Pain
Injections
Implantable Drug Pumps
Medical Management
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Pharmaceutical Treatment for Back Pain
Introduction
The general consensus in the field of spinecare is that medication should not be used as a sole therapeutic approach, but should be considered as part of a more comprehensive therapeutic approach utilizing other forms of intervention such as rest, activity modification, spinal manipulation, clinical nutrition, exercise, healthy lifestyle modification, stress reduction and as well as other non-surgical approaches. On the shelves of pharmacies there are dozens of different medications utilizing phrases such as pain reliever, non-aspirin pain reliever, pills for backaches, sleep aids and nighttime pain relievers. Even though over-the-counter medications do not require a physician’s prescription they still may produce adverse side effects.
The general consensus in the field of spinecare is that medication should not be used as a sole therapeutic approach, but should be considered as part of a more comprehensive therapeutic approach utilizing other forms of intervention such as rest, activity modification, spinal manipulation, clinical nutrition, exercise, healthy lifestyle modification, stress reduction and as well as other non-surgical approaches. On the shelves of pharmacies there are dozens of different medications utilizing phrases such as pain reliever, non-aspirin pain reliever, pills for backaches, sleep aids and nighttime pain relievers. Even though over-the-counter medications do not require a physician’s prescription they still may produce adverse side effects.
Injections
For many
years, spine specialists have utilized a variety of different injections in an
attempt to relieve back pain and reduce inflammation in the spine. The most often used spinal injections
include epidural steroid injections, nerve blocks and trigger-point
injections. They are performed to
target the involved area of the spine in order to promote earlier recovery,
reduce risk and to improve functionality.
One of the most common forms of spinal injections is the epidural
steroid injection (ESI). The
spinal epidural injection is used to deliver an anti-inflammatory chemical into
a space within the spinal canal.
ESI may be used to inject other pain-relieving substances, such as
Lidocaine. The epidural steroid
approach may also incorporate the injection of a saline solution to help flush
out inflammatory substances.
Commonly, epidural steroid injections used in an attempt to reduce
inflammation within the spine.
Epidural injections can be used for diagnostic localization and therapeutic intervention. The risks of spinal injections include bleeding, nerve damage, infection, and puncturing of the dura. Puncturing of the dura can lead to a leak of cerebrospinal fluid and a resultant severe “spinal� headache. Spine injections are typically performed by spine specialists such as neurosurgeons, orthopedic surgeons, physiatrists, anesthesiologists and pain management specialists. There is conflicting information about the value of various types of injections. Some research studies have questioned the long-term benefits of epidural steroid injections.
Epidural injections can be used for diagnostic localization and therapeutic intervention. The risks of spinal injections include bleeding, nerve damage, infection, and puncturing of the dura. Puncturing of the dura can lead to a leak of cerebrospinal fluid and a resultant severe “spinal� headache. Spine injections are typically performed by spine specialists such as neurosurgeons, orthopedic surgeons, physiatrists, anesthesiologists and pain management specialists. There is conflicting information about the value of various types of injections. Some research studies have questioned the long-term benefits of epidural steroid injections.
Implantable Drug Pumps
Individuals
who have disabling chronic back pain unresponsive to alternative methods may be
given the option of receiving a morphine-pump implant. The pump is a device that provides a
trickle of medication through a catheter-like tube that enters the spinal
fluid. One of the advantages of
this method over oral drug use is that a precise level of medication is
provided with a targeted tissue approach.
The dose requirement with an implantable drug pump is typically a
fraction of the dose required with an oral approach. For example, the dose of morphine utilized through an
implantable morphine pump is approximately one-three hundredth of the dose of morphine
that would have to be taken orally to deliver the same level of back pain
relief.
Medical Management
Back pain
and related neurological signs and symptoms may be managed with a
pharmaceutical approach. The
attending medical physician may prescribe medications such as non-steroidal
anti-inflammatory agents and/or steroidal anti-inflammatory agents to reduce
inflammation. The reduction of
inflammation is often associated with a reduction of pain. Tricyclic antidepressants may be used
to increase the quality of sleep and to help diminish the level of pain. Chronic pain may lead to the use of
narcotics in isolated cases.
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