The combination of drug therapies and spinal procedures has made back pain treatment very successful
Back pain treatment falls into one of four categories:
1. Drug therapies
2. Spinal injections
3. Spine surgery
4. Acupuncture, Chiropractic and physical therapy
Drug therapy is an important part of back pain treatment. Over the counter medications include NSAIDs (non-steroidal anti-inflammatories) and some pain relievers. NSAIDS such as aspirin, ibuprofen and naproxen reduce swelling and promote healing. In low doses, NSAIDS are also pain relievers. In higher doses taken on a regular basis, these drugs reduce inflammation but can cause stomach upset. A new class of NSAIDs, called COX-2 inhibitors, recently came on the market in the form of Vioxx and Celebrex. They were considered valuable because they had the same anti-inflammatory properties as other NSAIDs but did not create stomach problems. However, both of these drugs have been removed from the market due to concerns about increased risk of heart problems; they are currently being reevaluated by the makers and the FDA.
Analgesics such as acetaminophen are used to reduce pain but must be used carefully because long term use can have a damaging effect on the liver and kidneys. However, short term use for back pain treatment is fine.
Opioids such as morphine, codeine, or oxycodone-release are rarely used for back pain treatment and only if pain is severe. Due to their addictive nature, these drugs are not routinely prescribed, as many physicians believe they do more harm than good.
Muscle Relaxants such as cyclobenzaprine Flexeril®), diazepam (Valium®), carisoprodol (Soma®), or methocarbamol (Robaxin®) are often prescribed for severe pain. However, some experts believe that NSAIDs are just as effective as back pain treatment.
Spinal injections are also used for back pain treatment. A local anesthetic called Lidocaine is used to numb the injection site then a corticosteroid medication is injected along with the anesthetic in order to reduce inflammation in the affected areas.
Although most back pain treatment does not include surgery, there are some situations where surgery is required. For example, surgery is used to remove part of a disc that has herniated or ruptured (diskectomy), remove the bony plate connected to the vertebrae (laminectomy), widen the opening for the nerves (foraminectomy) or fuse vertebrae to together for more stability (fusion).
Finally, there are other types of back pain treatment that may or may not be useful. Physical therapy is part of a conventional medical approach and works to strengthen muscles and build flexibility and endurance. Chiropractic is an approach that uses spinal adjustment to create better nervous system function. Acupuncture is an approach from the Eastern tradition of medicine that is not well understood but can be helpful for some people; it is based on altering the flow of energy in the body.
