Medications Glossary

Drugs and medications that may be used to treat neck and back pain.

In this Medication Glossary for neck and back disorders, you can learn about different types of over-the-counter (OTC) and prescription drugs your doctor may recommend and/or prescribe to treat your spinal disorder.
Pharmacist with a digital tabletTerms and definitions that will help you better understand the drugs and medications used for back and neck pain.Analgesics
Analgesics, also known as painkillers, are pain-relieving drugs. Analgesics are available in both over-the-counter (OTC) and prescription forms. Examples of common analgesics are acetaminophen (Tylenol) and opioids.

Anticonvulsants
Also known as antiepileptics, anticonvulsants are most often used to manage epileptic seizures. However, they also reduce burning nerve pain associated with other chronic pain conditions, such as fibromyalgia. Research suggests that anticonvulsants decrease excess pain signals sent by damaged nerves, thus reducing the pain you feel. Gabapentin (Neurontin) is an example of an anticonvulsant medication.

Antidepressants
Antidepressants are typically used to treat mental and emotional disorders, but doctors may also prescribe antidepressants to help reduce pain and improve sleep. These drugs may be used treat pain associated with musculoskeletal disorders, such as fibromyalgia, rheumatoid arthritis, and spondylosis (spinal osteoarthritis). They stimulate the release of endorphins, the body’s natural pain killers. Since physical pain and emotional pain often go hand in hand, antidepressants can be especially effective at treating the multifactorial nature of pain. Common types of antidepressants prescribed for chronic back and neck pain include: tricyclic antidepressants (TCAs), serotonin and norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), and norepinephrine and dopamine reuptake inhibitors (NDRIs).

Biologics
Biologic drugs are a special, complex class of medications. Unlike typical drugs and medications manufactured from synthetic chemicals, biologic drugs are derived from living cells. An example of a biologic is etanercept (Enbrel), which is a biologic for spinal inflammatory arthritis.

Bisphosphonates
Bisphosphonates are commonly prescribed to treat osteoporosis, as they help increase bone mineral density in the spine and hips, and may help reduce the risk of fracture. Zoledronic acid (Reclast) is an example of a bisphosphonate.

Corticosteroids
Corticosteroids are powerful oral or injected prescription medications that help reduce inflammation (swelling). Prednisone (Deltasone) is an example of an oral corticosteroid.

COX-2 Inhibitors
COX-2 inhibitors are a class of prescription non-steroidal anti-inflammatory drugs (NSAIDs) that reduce pain and inflammation but with a lower risk of gastrointestinal side effects associated with traditional NSAIDs. Celecoxib (Celebrex) is an example of a COX-2 inhibitor.

Disease-modifying Anti-rheumatic Drugs (DMARDs)
Disease-modifying anti-rheumatic drugs may help slow or stop destructive changes in joints caused by rheumatoid arthritis and other types of spinal inflammatory arthritis. Methotrexate (Trexall) is an example of a DMARD.

Local Anesthetics
Local anesthetics block pain messages to nerves. These medications may be administered via injection or patch. Lidocaine (Anestacon) is an example of a local anesthetic.

Muscle Relaxants
Muscle relaxants are prescription medications commonly used to reduce the painful symptoms associated with muscle spasms. An example of a muscle relaxant is baclofen (Lioresal).

Neuropathic Agents
A neuropathic agent is a medication that acts on neuropathic pain. In other words, neuropathic agents will help treat your shooting, burning, and stinging nerve-related pain. Tricyclic antidepressants are a commonly-prescribed neuropathic agent.

Non-steroidal Anti-inflammatory Drugs (NSAIDs)
Non-steroidal anti-inflammatory drugs (NSAIDs) are a type of analgesic that relieves both pain and inflammation. NSAIDs are available in over-the-counter and prescription forms. Ibuprofen (Motrin) and diclofenac (Voltaren) are examples of NSAIDs.

Norepinephrine-Dopamine Reuptake Inhibitors (NDRIs)
Norepinephrine-dopamine reuptake inhibitors (NDRIs) are antidepressants that are chemically different compared to other types of antidepressants, but they work in similar ways. Bupropion (Wellbutrin) is an example.

Off-label Use
An off-label medication means it is being used outside the U.S. Food and Drug Administration (FDA) indication. An example of off-label medication use is prescribing an anticonvulsant for chronic pain. Anticonvulsants are FDA approved to treat epilepsy, so using them to treat chronic spinal pain is considered an off-label use. Off-label does not mean its unsafe, though, many off-label uses can safely address symptoms.

Opioids
Opioids, also called narcotics or Schedule II drugs, are extremely potent prescription analgesics that bear elevated risks of abuse and addiction. They should be taken only if you have severe chronic back and neck pain. These drugs work by essentially decreasing your perception of and reaction to pain. Meperidine (Demerol) and tramadol (Ultram) are examples of opioid pain relievers.

Over-the-counter Medications
Over-the-counter (OTC) medications may be purchased without a prescription.

Prescription Medications
Prescription medications may be obtained only with the documented consent and direction of a doctor.

Selective Serotonin Reuptake Inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that boosts your mood by allowing more serotonin to travel from neuron to neuron. More serotonin means you’ll perceive less pain. Fluoxetine (Prozac) is an example of an SSRI.

Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
Serotonin and norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressants that increases levels of both serotonin and norepinephrine by stopping their reuptake (reabsorption) into brain cells. Increases in these chemicals help maintain mental balance and reduce the amount of pain you feel. Duloxetine (Cymbalta) is an example of a SNRI.

Side Effects
All drugs and medications bear the risk for side effects, or potential adverse effects. Examples a medication side effects are gastrointestinal problems from long-term NSAID use or opioid-induced constipation. While some adverse effects cannot be avoided, you can minimize your risk for side effects by taking a medication only as directed.

Topical Medications
Topical medications are pain relievers that are applied to the skin as a cream, ointment, gel, spray, or patch. The lidocaine patch (Lidoderm) is an example of a topical pain reliever.

Tricyclic Antidepressants (TCAs)
Tricyclic antidepressants (TCAs) are antidepressants that are effective for chronic back pain. TCAs help regain balance by raising the levels of calming neurotransmitters—namely serotonin, norepinephrine, and dopamine—in your brain. This helps reduce your perception of pain. Amitriptyline (Elavil) is an example of a TCA.

Weaning
Medication weaning, or tapering, is a gradual, organized, and medically guided way to safely transition off certain medications, including opioids. Patients slowly reduce their dose to avoid adverse effects from abruptly quitting a medication. For example, your doctor may recommend stepping down from 5 pills to 4 pills for 2 weeks. Then 3 pills, then 2 pills in successive weeks.

Updated on: 07/30/18
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Questions to Ask Your Pharmacist or Doctor about Medications

It's essential to have clear communication with your doctor and pharmacist when it comes to taking drugs and medications. Understanding your treatment will better help you reduce your back and neck pain.
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