Medication (OTC & Prescription)

Pharmacological interventions

Pharmacological interventions include management of pain using medicinal preparations such as pain relieving capsules or injections.

Medications play an efficient role in the treatment of back or neck pain. Your doctor may prescribe several medications to help reduce pain and associated symptoms that are caused by unhealthy spinal conditions or deformities.

When healthcare professionals prescribe a medication regimen, the precise needs of the patient including severity and period of pain and medical history of the individual are considered in the treatment of chronic low back pain. The main aim of prescribing medications is to reduce the pain and increase the comfort level of the patient and reduce the danger of misuse or abuse of the medications.

Over-the-counter pain relievers

Over-the-counter pain relievers are medications available without a doctor’s prescription. They include acetaminophen, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and topical pain relievers.

  • Acetaminophen (Tylenol) and NSAIDs help to reduce fever and alleviate pain caused by general muscle aches and stiffness. Moreover, NSAIDs can also reduce inflammation. NSAIDs help relieve pain by reducing the level of prostaglandins (hormone-like substances) that cause pain
  • Topical pain relievers (Aspercreme, Ben-Gay, and Capsaicin) include creams, lotions and sprays that are applied to the skin of painful muscles or joints to ease pain

Non-steroidal anti-inflammatory drugs

These are known as NSAIDs and are found to be effective in reducing pain and inflammation of the hip and the knee. Caution must be taken while using NSAIDs for overdosing as they are known to cause hepatotoxicity. Patients with liver diseases must have extreme care while using them. They cause a range of side effects, chances of which increase with the concomitant use of diuretics, angiotensin converting enzyme inhibitors, angiotensin 2 receptor blockers, anticoagulants or oral corticosteroids

Opioid pain medications:

Because of possible toxicity to the body, physical dependence, and the loss of efficacy due to developmental tolerance and psychological dependence or addiction, opioid medical care or narcotic administration is widely rejected in the treatment of chronic back pain.

Opioids are typically prescribed for patients with chronic nonmalignant pain, including low back pain who experience high levels of comfort while not developing toxicity to the body or having any indication of psychological dependence or addiction. Opioid therapy should be considered as the last treatment option in cases of unrelieved pain despite alternative medications (such as use of non-opioid drugs). Patients should be informed regarding the side effects of opioids and suggested to follow-up with their doctor regularly. Monthly appointments should be scheduled to assess the dose of the drug until the patient experiences partial or complete relief of pain.

Corticosteroids: Corticosteroids are used to reduce swelling caused due to inflammation. When used to control pain, corticosteroids can be prescribed in the form of pills or injections.

Muscle relaxers: Muscle relaxers are drugs that are commonly used to treat acute muscle problems. Sometimes, they can help treat painful muscle spasms. These medications help in reducing muscle tone and tension in skeletal muscles. Some muscle relaxers have direct effect on the skeletal muscle fibers, while others work at the level of the spinal cord.

Glucosamine & Chondroitin Sulfate Supplementation

Glucosamine and Chondroitin Sulfate are the most common nutritional/diet supplements used in the treatment of arthritis pain and inflammation. Patients who suffer from osteoarthritis may benefit from taking these supplements. Osteoarthritis, also called degenerative joint disease is the most common form of arthritis. It occurs most often in older people. This disease affects the tissue covering the ends of bones in a joint (cartilage).In a person with osteoarthritis, the cartilage becomes damaged and worn out causing pain, swelling, stiffness and restricted movement in the affected joint.

Naturally, these supplements are found in the human bones, while their artificial origin is abstracted from animal products. These nutritional supplements may help alleviate joint pain and perhaps even slow the breakdown of cartilage or restorethe joint cartilage. These are one option among the non-surgical treatment options employedto reduce pain in joint diseases. Patientstaking glucosamine and chondroitin sulfate dietary supplements along with other osteoarthritis treatments may attain optimal levels of relief from osteoarthritis-related joint pain.

The regular dosage level for the supplements varies according to the age and weight of the individual.

Adverse effects:

The common side effects of Glucosamine and Chondroitin Sulfate may include:

  • Stomach upset
  • Nausea/Vomiting
  • Diarrhea
  • Burning sensation in the chest

These supplements should be taken with food to reduce some of these side effects. Always talk to your doctor before you start taking these supplements.

Contraindications:

Glucosamine and Chondroitin Sulfate supplements are not appropriate for everyone. Thereforetheyshould be taken onlyundermedical supervision in the following groups of patients:

  • Diabetic patients
  • Pregnant/Breast-feeding women
  • Young children
  • Patients allergic to shellfish
  • Patients on Anticoagulant (Coumadin) therapy