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 Non-Operative Treatment: Pharmacological Pain Management

Back and neck pain can be miserable! Injury, herniated disc, spinal stenosis, osteoarthritis, vertebral compression fracture even a simple back sprain can cause life-altering pain. Back pain is one of the foremost reasons people seek medical care at the San Diego Center for Spinal Disorders (SDCSD). Fortunately, few cases of back pain require immediate spine surgery and many can be treated with medication and physical therapy.

Yesterday vs. Today
Years ago patients with back pain were told to get off their feet and stay in bed for a week. After much scientific study, it has been proven that inactivity does little to help conquer back pain. Today we want to help you return to activity as quickly as possible.

The first step may include certain medications to control pain. When pain is controlled you may be able to participate in a physical therapy (PT) program. PT gives patients the tools needed to become strong and flexible, while learning proper biomechanics and injury prevention skills. Click here to read more about physical therapy at SDCSD.

Medications - Overview
The various types of medications used to control back and neck pain can be placed into 4 main groups. Each has a different purpose.

1. Narcotics (opioids) Short-term acute pain control
2. Muscle relaxants Relieve muscle spasms and cramping
3. Non-steroidal anti-inflammatory

Reduce inflammation to alleviate pain (NSAIDs)

4. Analgesics Long-term pain control

Narcotics (Opioids)
Pharmacological Pain Management.Narcotics are used for a short period of time to control acute pain, which is severe, short-term, and self-limiting. When narcotics are taken long-term the body builds up a tolerance to the medicine and requires larger doses to control the same level of pain. All narcotics are derived from the opium poppy. The opium poppy contains several narcotic compounds including morphine and codeine.

Muscle relaxants
Medication to relax muscles can help to relieve spasms, cramping, and tightness that can cause pain. This type of medication acts on the central nervous system to loosen muscles. Sometimes a pain reliever and a muscle relaxant are prescribed together.

Non-Steroidal Anti-Inflammatory Medications
There are hundreds of injury and spinal disorder scenarios that cause soft tissue inflammation. The nerve roots become irritated and inflamed from spinal stenosis or a herniated disc. Muscles become inflamed due to overuse or whiplash type injuries. Irritated, inflamed and swollen tissues cause pain. Non-steroidal anti-inflammatory drugs (NSAIDs) help to reduce inflammation to control this pain.

Pain Relieving Patches and Creams
Many patients suffer chronic pain from a spinal disorder. For some conditions, a topical analgesic may be helpful. These must be used with care, as your doctor will explain.

Medication Side Effects
Taking prescription or over-the-counter (OTC) medications has risks of side effects, drug interaction and liver damage. For those reasons it is important to tell your doctor everything about your past medical history, including allergies, medications (including OTCs) taken daily, and supplements (vitamins, herbs).

Before you take a prescription or OTC medication, be aware of the side effects listed either with the prescription or on the bottle.


Table 1: Tell Your Doctor if You Suffer These Side Effects

Dizziness

Headache

Drowsiness

Constipation

Dry mouth

Blurred Vision

Nausea

Vomiting

Table 2: CALL Your Doctor if You Suffer These Side Effects

Fast or slow heartbeat

Trouble breathing

Facial swelling

Hives, skin rash, itching

Severe confusion or tiredness

Yellowing of the skin or eye

Black tarry stools

Severe weakness

Cold, clammy skin

Trouble urinating

Hallucinate

Behavioral changes

Conclusion
The physicians and staff at SDCSD are totally committed to helping our patients with effective pain management. We combine our medical expertise with careful assessment of each patient's situation to develop the best strategies. We also take the time for thorough education about all treatments so that you can experience the best results.

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