Drugs, Medications, and Spinal Injections for Herniated Discs
Herniated discs often compress surrounding nerve roots, causing pain and swelling. The severity of your symptoms determines what medications you may need, and there are a variety of options available. But it's important to note that drugs and medications will not cure your herniated disc; they may relieve the pain associated with the herniated disc.
As with all drugs or medications, you should first consult your doctor. You will typically use over-the-counter medications first and then progress to prescription drugs, if necessary. If you still need relief, spinal injections send potent medication straight to the source of your pain.
Over-the-Counter Medications for Herniated Discs
- Acetaminophen: Acetaminophen, such as Tylenol, is a great first-line of defense. However, it's not for everyone. While acetaminophen is a good painkiller, it won't reduce your inflammation.
- Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs relieve pain and reduce inflammation, which is how they differ from acetaminophen. Examples of NSAIDs include aspirin, ibuprofen (eg, Advil), or naproxen (eg, Aleve). Some NSAIDs are not suitable for those who have a history of heart attack or stomach ulcers
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- Prescription NSAIDs: Prescription-strength NSAIDs are available if the over-the-counter variety proves unsuccessful. Examples include a COX-2 inhibitor such as celecoxib (eg, Celebrex).
- Muscle relaxants: Spinal muscle spasms often accompany herniated disc. In such cases, a muscle relaxant may provide relief. Diazepam (eg, Valium) is an example of a muscle relaxant.
- Oral steroids: Oral steroids (also called corticosteroids) may be effective at reducing swelling. These medications are prescribed for short-term use. Multiple adverse effects have been associated with prolonged steroid use. Dexamethasone (eg, Decadron) and methylprednisolone (eg, Medrol) are examples of oral steroids.
- Opioids (narcotics): Narcotic pain medications, such as codeine or morphine, alleviate intense pain and should be used in extreme cases. Note that many patients develop a tolerance to opioids and require higher doses to get relief. These pain medications can also be addictive, so use them only under careful supervision.
- Anti-depressants: Anti-depressants block pain messages from getting to your brain and increase the effects of endorphins, which are essentially your body's natural painkillers. Another added benefit—anti-depressants help you sleep better.
- Epidural steroid injections: Epidural steroid injections contain corticosteroids, which are potent anti-inflammatory agents that quickly relieve pain caused by compressed nerves. Injected near the spinal nerves, the medication can offer significant pain reduction with the first dose, but it may take a few days to work. No more than 3 injections are usually given in a year.
Medications typically have side effects and other considerations that you should take into your decision process on what you should try. Discuss all medications—even if they're over-the-counter and pose no apparent risk—with your doctor first. It's also important to note that you should not solely rely on pain relievers and injections to treat pain from your herniated disc. Incorporating physical therapy and exercise into your treatment will yield the best results.