Treatments for back pain: Pharmacological therapy

Treatments Basis, indications and risk Patient information Postural hygiene Exercise Maintaining level of Activity Bed rest Pharmacological therapy Analgesics Non steroideal antiinflammatory drugs Muscle relaxants Other Neuroreflexotherapy (NRT) Spinal column surgery Surgery for Pain and Pain Clinics Vertebral manipulation Behavioral treatment Epidural injections Facet joint infections Trigger point and ligament infections Rhizotomy Corsets and lumbar belts Traction Physical therapy/physiotherapy Electromyografic Feedback TENS: Transcutaneous electrical Nerve Stimulation Shoe insoles and shoe lifts Acupunture Recommended treatments

Analgesics

Objective

To reduce pain.

Theoretical base

Different types of analgesics act in different ways. In general, they interfere with the activation mechanisms of pain detecting or conductive nerves, or with the mechanisms of pain transmission.

Evidence of efficacy

Available scientific studies prove the efficacy of analgesics for reducing the intensity of back pain episodes.

Risks and contraindications

When taking a pharmacological agent orally, by suppository, or by intramuscular injection, the drug is introduced into the blood and spreads throughout the body.

Most common side effects of analgesics are drowsiness and constipation; they may appear in up to 50% of patients.

The portion reaching the structures involved in back pain may improve it, but the remaining portion is useless and may have adverse effects. Therefore, it is quite important to avoid self-medicating and only taking medications if prescribed by a physician.

Drugs that have previously caused allergies must not be used, just as those deemed unadvisable by your physician for your specific case.

Indications

The use of analgesics is recommended for episodes of acute pain, or during a crisis or exacerbation of chronic pain. In general, with exceptions, they should not be used for more than 14 days.

Due to lesser side effects, some of the existing recommendations based on scientific evidence advise to initially start with acetaminophen or others with paracetamol.