Drugs, Medications, and Spinal Injections to Relieve Back Pain
To accurately and most effectively treat your back pain, your doctor will need to make a diagnosis. What spinal condition is causing your back pain? With that information, he or she will be better able to prescribe medications and/or spinal injections to deal with your symptoms. The medications and injections should be part of a larger treatment plan that includes other treatment options such as physical therapy. In other words, medication alone is not the ultimate solution to your back pain.
The severity and cause of your back pain determines the prescription for medications or injections, but your doctor may suggest:
Over-the-Counter Medications for Back Pain
- Acetaminophen: Tylenol is an example of an acetaminophen, a type of medication that has proven to be a good pain reliever. Your doctor may call this an analgesic, but most of us refer to acetaminophen medications as painkillers. They don't help reduce inflammation, though.
- Over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs): These will help reduce swelling (or inflammation) while relieving your pain; that's how NSAIDs differ from acetaminophen. If an over-the-counter NSAID is an option for you, you have plenty to choose from. You can use ibuprofen (Advil), aspirin, or Aleve.
Prescription Medications for Back Pain
- Muscle Relaxants: If you have chronic back pain caused by muscle spasms, you may need a muscle relaxant, which will help stop the spasms.
- Anti-depressants: As surprising as it may seem, anti-depressants can be effective drugs for treating pain because they block pain messages on their way to the brain. They can also help increase your body's production of endorphins, a natural pain killer.
- Opioids: In the most extreme cases, and only under careful supervision, you doctor may also prescribe an opioid, such as morphine or codeine.
As with all medications, you must follow your doctor's advice precisely. Never mix over-the-counter and prescribed drugs without consulting your doctor. Also, as your doctor decides what to prescribe, be sure to tell him or her if you're using any herbal supplements, in addition to any other prescription medications you're on.
Spinal Injections for Back Pain
- Epidural Steroid Injection: This is one of the most common injections. It targets the epidural space, which is the space surrounding the membrane that covers the spine and nerve roots. Nerves travel through the epidural space and then branch out to other parts of your body, such as your legs. If a nerve root is compressed (pinched) in the epidural space, you can have pain that travels down your back and into your legs (commonly called sciatica, although the technical medical term is radiculopathy).
An epidural steroid injection sends steroids—which are very strong anti-inflammatories—right to the nerve root that's inflamed. This is a pain management therapy, so it's best to have a well-trained pain management specialist do the injection. You'll probably need 2-3 injections; generally, you shouldn't have more than that because of the potential side effects of the steroids.
- Other Injections: Depending on your diagnosis, your doctor may suggest other types of spinal injections. For example, you can have a sympathetic nerve block, which targets the nerves that control some of your body's involuntary functions. The sympathetic nerves control things like opening and closing blood vessels. Or you may have a facet joint injection. Facet joints in your spine help you move and provide stability. If they become inflamed, though, you'll have pain. A facet joint injection will numb the joint and can reduce your pain.