Medications for Neck & Back Pain

OVER-THE-COUNTER PAIN RELIEVERS

Over-the-counter means you can buy them without a prescription.

Most health care providers recommend acetaminophen (such as Tylenol) first because it has fewer side effects than other drugs. Do not take more than 3 grams (3,000 mg) on any one day, or over 24 hours. Overdosing on acetaminophen can cause severe damage to your liver. If you already have liver disease, ask your doctor if acetaminophen is OK for you to take.

If your pain continues, your provider may suggest nonsteroidal anti-inflammatory drugs (NSAIDs). You can buy some NSAIDs, such as ibuprofen and naproxen, without a prescription. NSAIDs help reduce the swelling around the swollen disk or arthritis in the back.

NSAIDs and acetaminophen in high doses, or if taken for a long time, can cause serious side effects. Side effects include stomach pain, ulcers or bleeding, and kidney or liver damage. If side effects occur, stop taking the drug right away and tell your provider.

If you are taking pain relievers for more than a week, tell your provider. You may need to be watched for side effects.

 

MUSCLE RELAXANTS

Your provider may prescribe a medicine called a muscle relaxant. Despite its name, it does not work directly on muscles. Instead, it works through your brain and spinal cord.

This drug is often given along with over-the-counter pain relievers to relieve the symptoms of back pain or muscle spasm.

Examples of muscle relaxants include:

  • Carisoprodol
  • Cyclobenzaprine
  • Diazepam
  • Methocarbamol

Side effects of muscle relaxants are common and include drowsiness, dizziness, confusion, nausea, and vomiting.

These medicines can be habit-forming. Talk to your provider before using these drugs. They may interact with other medicines or make certain medical conditions worse.

Do not drive or operate heavy machinery while taking muscle relaxants. Do not drink alcohol while taking these drugs.

 

ANTIDEPRESSANTS

Antidepressants are normally used to treat people with depression. But, low doses of these medicines can help with chronic low back pain, even if the person does not feel sad or depressed.

These drugs work by changing the levels of certain chemicals in your brain. This changes the way your brain notices pain. Antidepressants most commonly used for chronic low back pain also help you sleep.

Antidepressants most often used for back pain are:

  • Amitriptyline
  • Desipramine
  • Duloxetine
  • Imipramine
  • Nortriptyline

Common side effects include dry mouth, constipation, blurred vision, weight gain, sleepiness, problems urinating, and sexual problems. Less commonly, some of these drugs can also cause heart and lung problems.

Do not take these drugs unless you are under the care of a provider. Do not stop taking these drugs suddenly or change the dose without also talking with your provider.

 

ANTI-SEIZURE OR ANTICONVULSANT MEDICINES

Anticonvulsant medicines are used to treat people with seizures or epilepsy. They work by causing changes in the electric signals in the brain. They work best for pain that is caused by nerve damage.

These drugs may help some people whose long-term back pain has made it hard for them to work, or pain that interferes with their daily activities. They can also help relieve radiating pain that is common with back problems.

Anticonvulsants most often used to treat chronic pain are:

  • Carbamazepine
  • Gabapentin
  • Lamotrigine
  • Pregabalin
  • Valproic acid

Common side effects include weight gain or weight loss, upset stomach, loss of appetite, skin rashes, drowsiness or feeling confused, depression, and headaches.

Do not take these drugs unless you are under a provider’s care. Do not stop taking these drugs suddenly or change the dose without also talking with your provider.

 

NARCOTIC PAIN RELIEVERS

Narcotics, also called opioid pain relievers, are used only for pain that is severe and is not helped by other types of painkillers. They work well for short-term relief. Do not use them for more than 3 to 4 weeks unless instructed by your provider to do so. Based on the available literature on the pros and cons related to narcotic pain medications, we strongly recommend not using them beyond a certain point.

Narcotics work by binding to receptors in the brain, which blocks the feeling of pain. These drugs can be abused and are habit-forming. They have been associated with accidental overdose and death. When used carefully and under a provider’s direct care, they can be effective in reducing pain.

Examples of narcotics include:

  • Codeine
  • Fentanyl — available as a patch
  • Hydrocodone
  • Hydromorphone
  • Morphine
  • Oxycodone
  • Tramadol

Possible side effects of these drugs include:

  • Drowsiness
  • Impaired judgment
  • Nausea or vomiting
  • Constipation
  • Itching
  • Slowed breathing
  • Addiction

When taking narcotics, do not drink alcohol, drive, or operate heavy machinery.

 

MEDICAL MARIJUANA

Marijuana is best known as a drug that people smoke or eat to get high. It is derived from the plant Cannabis sativa. Possession of marijuana is illegal under federal law. Medical marijuana refers to using marijuana to treat certain medical conditions. In the United States, over one half of the states have legalized marijuana for medical use. Marijuana leaves and buds contain substances called cannabinoids. THC is a cannabinoid that can affect the brain and change your mood or consciousness. Different varieties of marijuana contain different amounts of cannabinoids. This sometimes makes the effects of medical marijuana hard to predict or control. The effects also may differ depending on whether it is smoked or eaten.

You can only get medical marijuana if you have certain conditions. The conditions marijuana can treat varies from state to state. The most common ones include:

  • Cancer
  • HIV/AIDS
  • Seizures and epilepsy
  • Glaucoma
  • Severe chronic pain
  • Severe nausea
  • Extreme weight loss and weakness (wasting syndrome)
  • Severe muscle spasms
  • Multiple sclerosis

Possible physical symptoms from using marijuana include:

  • A fast or irregular heartbeat
  • Dizziness
  • Slow reaction times
  • Drowsiness

Possible mental or emotional side effects include:

  • A strong feeling of happiness or well-being
  • Short-term memory loss
  • Trouble concentrating
  • Confusion
  • Decreased or increased anxiety

Providers are not allowed to prescribe medical marijuana to people younger than age 18. Other people who should not use medical marijuana include:

  • People with heart disease
  • Pregnant women
  • People with a history of psychosis

Other concerns linked to marijuana use include:

  • Dangerous driving or other risky behaviors
  • Lung irritation
  • Dependence or addiction to marijuana

Source: MedlinePlus Medical Encyclopedia

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