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The Strongest Painkillers for Back Pain

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Painkillers are a reliable way of relieving chronic pain in the back and enabling patients suffering from it to get some peace of mind. There are several options in the market that vary greatly on the basis of efficacy, strength, dosage, and side effects. Depending on the severity of back pain, some may be fine taking over-the-counter painkillers or may require narcotic pain medicine.

So what are the strongest painkillers for back pain? Over-the-counter pain medications, narcotic painkillers and opioids, muscle relaxants and antispasmodics, antidepressants, anticonvulsants, steroid pain relievers, and a number of topical painkillers like capsaicin and lidocaine are some of your options against back pain. For best results, consult with your doctor to know the right dose of painkillers to take or if there are medications you must avoid due to allergies.

Efficacy of Strong Painkillers for Back Pain

Painkillers such as opioids and NSAIDs can be quite effective for minimizing the intensity of chronic pain, but they aren’t the end-all solution by themselves. Patients are usually required to take other medication that treats the underlying issue along with these painkillers for effective treatment.

The type and dosage of painkillers also tend to depend on the line of treatment chosen for the disease, as doctors need to ensure the two medications don’t interfere with each other. Painkillers prevent you from feeling the pain by interacting with your body’s nerve endings, cells, neurological system, and brain.

These nerve endings are present throughout your body. Low back pain can be detected by some of these nerve endings in addition to discomfort in other areas. Your body’s cells release substances known as prostaglandins when they are injured or harmed.

Nerve endings are particularly sensitive to this substance and use it to detect pain. When prostaglandin is released, the nerve endings react by sending pain and injury signals to the brain via the neurological system. These signals communicate to the brain the location and intensity of the pain.

Pain relief medications like ibuprofen prevent damaged or wounded cells from producing and releasing prostaglandin. The absence of this molecule ensures that the brain doesn’t receive these pain signals from the cells as quickly or clearly. As long as the cells aren’t releasing the chemical, your pain either disappears or is minimized. On the other hand, painkillers such as acetaminophen work in the brain to block the perception of pain.

Types of Painkillers for Back Pain

There are several painkillers that have great potency in relieving upper or lower back pain in your back. These include OTC pain medication, antidepressants, and analgesics, among others. They can also be administered by intaking them orally or injecting them through the bloodstream.

1) Over-the-Counter Pain Medication

Over-the-counter pain medication is perhaps the most common form of painkillers that your doctor may recommend for your back pain. A good example would be Tylenol (acetaminophen). Non-steroidal anti-Inflammatory drugs (NSAIDs) such as ibuprofen, diclofenac, and naproxen also come under this category. Mild doses of these painkillers can be obtained even without a prescription.

Two COX-2 inhibitors with similar effects include the anti-inflammatory medicines celecoxib and etoricoxib (also referred to as coxibs). These drugs are rarely used because they’re not approved for pain management. Since there isn’t enough proof to state that paracetamol genuinely reduces back pain, some research seems to suggest that it’s just the placebo effect.

2) Narcotic Painkillers and Opioids

Opioid medications are potent painkillers that require a prescription. Some examples include hydrocodone, tramadol, and oxycodone. They’re generally recommended for severe acute pain, such as managing pain during the postoperative phase. Opioids are sometimes used by some patients to treat chronic pain conditions such as debilitating back pain. They trigger the release of endorphins in your brain, which make you feel good and make them addictive substances.

Opioid medicines have a rather significant risk of abuse and misuse due to their addictive nature; medical professionals generally tend to be cautious about the use of opioids amongst their patients. Narcotic painkillers and opioids are extremely effective in managing pain for short periods of time. They work by binding themselves to pain receptors in the brain to block any sensation of pain. Some examples of narcotic drugs include:

3) Muscle Relaxants and Antispasmodics

Muscle relaxants and antispasmodics help manage pain by relaxing the muscles to release the tension in them. Back pain resulting from musculoskeletal issues associated with conditions such as whiplash injuries can be treated using muscle relaxants. A muscle relaxant can only be obtained with a prescription and is typically administered for a brief period of time (usually 2 to 3 weeks), though some people may use them for longer periods if pain continues to persist.

An interesting aspect of muscle relaxants is the fact that they actually work in the brain and spinal cord; not on the actual muscles themselves. Common examples of muscle relaxants include Methocarbamol, Diazepam, Carisoprodol, and Cyclobenzaprine.

Meanwhile, antispasmodics can be grouped into two unique categories. Pain medicine that relieves pain by blocking the chemicals in the brain are known as benzodiazepines (or benzos), while nonbenzodiazepines can decrease chronic lower back pain by acting on the entire nervous system.

4) Antidepressants

Certain types of antidepressants that are usually used to treat depression have been effective in mitigating back pain by serving as pain relievers. Antidepressants are usually considered to be prescription medication. These medications alter the amounts of specific brain chemicals to alter your perception of pain. The most popular antidepressants for persistent low back pain also aid in sleep. These include the likes of:

5) Anticonvulsants

Anticonvulsants like gabapentin (Neurontin) and pregabalin (Lyrica) function by simulating a neurotransmitter that inhibits the nerve signals that produce neuropathic pain in the brain. These drugs have the ability to alter your brain’s pain signals by changing the electric signals it receives. They’re usually recommended to alleviate back pain resulting from nerve pain and injury. For example, neuropathic pain may be experienced by those who have a herniated disc.

These medications may be helpful for some people whose chronic back pain makes it difficult for them to work or interferes with their everyday activities. They can also aid in reducing radiating pain, which is a typical symptom of back issues. Anticonvulsants can only be obtained with a prescription. Popular anticonvulsants used as painkillers for back pain include:

6) Steroidal Pain Relievers

Prednisone and methylprednisolone are two examples of oral steroids that have anti-inflammatory properties. A doctor may recommend them to treat sudden, inflammatory low back pain. Typically, oral steroids are administered for brief periods of therapy. Due to the possibility of major adverse effects, a physician must suggest a tapering schedule for long-term steroid use.

7) Topical Pain Medications

Topical painkillers include creams, gels, and patches that are applied directly to the skin. These can be quite effective for treating back pain. They’re available over-the-counter, although a prescription may be required for higher strengths. They are generally advocated for the relief of localized pain in the back, legs, or other parts of your body. Topical pain medication includes:

Types of Painkillers for Back Pain

Potential Complications Associated With Strong Painkillers

There are several side effects, risks, and potential complications that may arise from taking strong painkillers for back pain. Patients with a history of gastrointestinal diseases shouldn’t take over-the-counter (OTC) pain medicine for long periods of time as NSAIDs have the risk of causing stomach ulcers, and kidney functions stress and may affect other internal organs.

Opioids and narcotic pain medicine have the risk of being addictive. If used for more than the prescribed period of time, you might get addicted to these drugs. Moreover, your body may develop a tolerance to these drugs, which may result in you requiring stronger doses to alleviate the pain. Dangerous doses of opioids can cause breathing problems, slow heart rate, confusion, mental fogginess, or constipation.

Muscle relaxants are similar to opioids in the sense that they’re addictive and can be habit-forming. They may also interfere with the action of other medications, which can cause your condition to worsen. Drinking alcohol or operating heavy machinery while taking muscle relaxants are also dangerous, so avoid doing these.

Antidepressants can have a series of side effects such as dry mouth, sleepiness, unintentional weight gain, constipation, urine problems, blurred vision, sexual problems, heart problems, and lung problems.

Meanwhile, anticonvulsants can result in an uneasy stomach, nausea, unintentional weight loss, loss of appetite, drowsiness, skin rashes, and even depression. These drugs must not be consumed without the prescription of a medical provider.

Types of Patients Who Should Avoid Taking Strong Painkillers

While painkillers can help with pain relief, there are some types of patients who should abstain from taking strong pain medicine, as their condition might be a contraindication of their intake. It’s always recommended to take a medical opinion before starting a dose of painkillers. The following types of patients should be cautious while taking strong painkillers:

Get Reliable Pain-Relief Solutions at New York Pain Care

Painkillers come under a category of medication called analgesics which have the ability to reduce pain by morphing your brain’s perception of pain. However, you’ll need to take appropriate medication and undergo medical procedures to treat your back pain to address the underlying issue.

At New York Pain Care, we identify the cause of your pain and formulate a treatment solution that will put you back on track to a pain-free life at the earliest. Our team of doctors will guide you through each pain relief procedure and ensure that you’re able to receive treatment that you feel comfortable receiving. Get to the source of your pain and get your peace of mind back by contacting us today for a consultation.

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Page Updated on Aug 10, 2022 by Dr. Hosny (Interventional Spine Specialist) of New York Pain Care
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