Back Pain

Back pain can be treated with a variety of medications and treatments.

Chiropractic. 

Many sources of back pain can be relieved by a chiropractic care. The most common therapeutic procedure performed by chiropractors (doctors who specialize in chiropractic medicine) is typically called a “chiropractic adjustment,” but is also referred to as “spinal manipulation.” Injured tissues undergo physical and chemical changes that can cause inflammation, pain, and diminished function for the sufferer. The purpose of an adjustment is to restore joint mobility and relieve pain.  Manipulation, or adjustment of the affected joint and tissues helps restore mobility, which alleviates pain and muscular tension, allowing the inflamed tissue to heal.

Pain relief medications.

These medications come in different forms and strengths. They are available as prescription or over-the-counter (OTC) medications and can treat various type of pain, including acute and chronic conditions and post-surgical discomfort. All medications have side effects, and many pain-relieving medications can be highly addictive. Speak with your doctor about what side effects you can expect from the medications you are taking.

Over-the-counter (OTC) pain medications include:

• Acetaminophen (Tylenol, aspirin-free Excedrin). Acetaminophen works on the parts of the brain that receive the “pain messages.”
• Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Motrin/ Advil) or naproxen (Aleve and Naprosyn). NSAIDs also reduce inflammation (swelling and irritation) and are also available in prescription strength.
• Topical pain relievers are also available without a doctor’s prescription. These products include creams, lotions, or sprays that are applied to the skin in order to relieve pain from sore muscles and arthritis. Topical pain relievers may be especially effective in dealing with the pain of arthritis in joints (including knee) back pain, and even headache pain.  These include:
  • Counterirritants, such as menthol and camphor, which create a burning or cooling sensation to distract from the pain
  • Salicylates, which relieve pain using the same ingredients as aspirin.
  • Capsaicin, the substance responsible for the spice of hot chili peppers, which relieves pain topically in an unknown manner.

Prescription pain relievers include:

• Corticosteroids. Prescription corticosteroids provide relief for inflamed areas of the body by easing swelling, redness, itching, and allergic reactions. These include:
  • Bethamethasone (Celestone)
  • Prednisone
• Opioids. These are narcotic pain medications that contain natural, synthetic or semi-synthetic opiates. Opioids are often used for acute pain, such as short-term pain after surgery. MedlinePlus, a service of the U.S. National Library of medicine warns that these drugs can be abused, can be addictive, and have been associated with accidental overdose deaths. Always take opioids precisely as prescribed.  Typically, prescriptions should not last more than three or four months:
  • Codeine
  • Fentanyl (Duragesic) — available as a transdermal patch
  • Hydrocodone (Vicodin)
  • Hydromorphone (Dilaudid)
  • Meperidine (Demerol)
  • Morphine (MS Contin)
  • Oxycodone (Oxycontin, Percocet, Percodan)
  • Tramadol (Ultram)

Surgery. 

Some cases of back pain may require surgical intervention. Commonly performed surgical procedures include:

• Minimally invasive spine surgery (MISS). This is a procedure that uses specially designed surgical instruments to access the spinal column through small incisions. Procedures that can be performed through minimally invasive spine surgery (MISS) include:
  • Discectomy, in which a damaged lumbar disk, the cartilaginous cushioning between two vertebrae, is removed.
  • Fusions, in which vertebrae and disks are fused to reduce the stress placed on the spinal nerve by movement.
• Endoscopic surgery. Endoscopic surgeries are minimally invasive procedures performed with the use of a video probe that allows surgeons to see the affected spinal area through a small incision. Procedures that can be performed endoscopically include:
  • Scoliosis surgery
  • Kyphosis surgery
  • Discectomies
  • Fusions
• Foraminectomy/Foraminotomy, in which the foramen, a natural tunnel found in vertebrae is widened through the removal of surrounding bone and/or tissue.
• Intradiscal Electrothermal Therapy (IDET), in which low levels of heat are delivered to damaged vertebral discs through a fine wire in order to relieve disc-related pain.
• Kyphoplasty, in which bone cement is used to reinforce the vertebral column.
• Laminectomy/Laminoplasty, in which the lamina, a portion of the vertebrae, is partially or fully removed in order to free up space for the spinal nerves.