What’s the best medication for back pain?

Patients often ask this, especially if they’ve recently surveyed the multitude of choices at their local pharmacy.

When it comes to back pain, NSAIDs can be extremely useful when used properly.

There are 7 different chemical structural types into which NSAIDs can be classified. While some are ‘prescription only’, understand that the mechanism of all NSAIDs (nonsteroidal antiinflammatory drugs) is: to reduce swelling, without steroids (cortisone or similar.)

What’s the downside? They don’t affect everyone exactly the same, but NSAIDs in general have the potential to affect your blood pressure, and NSAIDs all have the potential to cause bleeding in the GI tract, although some (ie, celebrex) may provide less risk to people with stomach or GI problems.  NSAIDs are generally not prescribed to people with aspirin allergies or kidney disease.

The upside? NSAIDs won’t make you ‘high’ and NSAIDs do not have the addictive potential as that of  painkillers such as percocet, vicodin or oxycontin (these particular medicines block pain, but do nothing to reduce swelling or inflammation.) On the other hand, NSAIDs work by blocking a mechanism causing inflammation, swelling and pain.

An NSAID is often one of the first medications prescribed for back pain and sports injuries.

Which one of those NSAIDs works best? Answer: none of them is a ‘super drug’ over all the rest. Some may last longer in the blood stream than others (ie, aleve lasts longer than motrin) however there’s no difference in their ability to stop swelling and inflammation.

Check with your physician if you have a problem causing you to take an over-the-counter NSAID for more than a week: its time to get properly diagnosed for more specific treatment.

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