Back Pain
Medications, Benefits, Risks and Side
Effects
Pain Medication
Medication is one of
the most common
methods of treating
BACK PAIN. Doctors
may use various
combinations and
doses of medicine.
Ask your health care
provider to tell you
more about the
medicine you are
taking, and don’t
take any new medicine
without first
checking with your
doctor or nurse.
The list below
describes the
benefits and risks of
the different types
of medicines used to
relieve all types of
pain.
Nonopioids -
Examples:
Acetaminophen,
aspirin, ibuprofen
Benefits:
These drugs
control mild to
moderate pain.
Some can be
bought
over-the-counter
(without a
prescription).
Risks:
Some of these
medicines can
cause stomach
upset. They also
can cause
bleeding in the
stomach, slow
blood clotting
and kidney
problems.
Acetaminophen
does not cause
these side
effects, but
high doses of it
can hurt the
liver. Drugs
that include
salicylates,
ibuprofen and
acetaminophen
may affect blood
platelets.
Opioids -
Examples: Morphine,
hydromorphone,
hydrocodone,
oxycodone, codeine,
fentanyl, methadone
Benefits:
Control moderate
to severe pain
and do not cause
bleeding.
Risks:
May cause
constipation,
sleepiness,
nausea and
vomiting.
Opioids sometime
cause problems
with urination
or itching. They
may also slow
breathing,
especially when
they are first
given, but this
is unusual in
people who take
opioids on a
regular basis
for pain. (More
on opioid side
effects...)
Antidepressants
- Examples:
Amitriptyline,
imipramine, doxepin,
trazodone
Benefits:
Help control
tingling or
burning pain
from damaged
nerves. They
also improve
sleep.
Risks:
May cause dry
mouth,
sleepiness and
constipation.
Some cause
dizziness and
lightheadedness
when a person
stands up
suddenly.
Antiepileptics
- Example: Gabapentin
Benefits:
Antiepileptics
help control
tingling or
burning from
nerve injury.
Risks:
They may hurt
the liver and
lower the number
of red and white
cells in the
blood. It is
important to
have regular
blood tests to
check for these
effects.
Steroids -
Examples: Prednisone,
dexamethasone
Benefits:
Steroids (also
known as
corticosteroids)
help relieve
bone pain, pain
caused by spinal
cord and brain
tumors, and pain
caused by
inflammation.
Steroids also
increase
appetite.
Risks:
They may cause
fluid to build
up in the body.
May also cause
bleeding,
irritation to
the stomach,
increased blood
sugar, muscle
weakness and
thrush.
Confusion is a
problem for some
patients when
they take
steroids.
Side Effects of
Pain Medication
All medicines can
have some side
effects, but not all
people get them. Some
people have different
side effects than
others. Most side
effects happen in the
first few hours of
treatment and
gradually go away.
Each one is an
anticipated side
effect, and most can
be treated so that
the pain can be
effectively managed.
If the side effects
cannot be alleviated,
doctors may switch a
patient’s pain
medication to make
sure a patient gets
the maximum pain
control with minimum
side effects. The
benefits and risks of
various categories of
pain medicine are
outlined in the next
section.
Chronic back pain is
most commonly treated
with pain medication.
Some of the most
common side effects
of pain medication
are:
Constipation:
(not being able
to have a bowel
movement): The
best way to
prevent
constipation is
to drink lots of
water, juice and
other liquids,
and to eat more
fruits and
vegetables.
Exercise also
helps to prevent
constipation.
Your doctor or
nurse may also
give you a stool
softener or a
laxative. (More
on preventing
constipation...)
Nausea and
vomiting:
When this
happens, it
usually only
lasts for the
first day or two
after starting a
medicine. Tell
your doctors and
nurses about any
nausea or
vomiting. They
can give you
medicine to stop
these side
effects. (More
on managing
nausea and
vomiting...)
Sleepiness:
When first
starting to take
pain
medications,
some patients
may feel drowsy
or sleepy. For
most patients,
this side effect
usually
disappears
within one to
three days. Talk
to your doctor
or nurse if this
is a problem for
you.
Slowed
breathing:
This sometimes
happens when the
amount of
medicine you are
taking is
increased. Your
doctor or nurse
can tell you
what to watch
for and when to
report slowed
breathing.
More serious side
effects of pain
medicines are rare.
As with the more
common side effects,
they usually happen
in the first few
hours of treatment.
More serious side
effects include
trouble breathing,
dizziness and rashes.
If you have any of
these side effects,
you should call your
doctor or nurse right
away.
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