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Back Pain Treatment

Whoever said 'just say no' to drugs clearly never had to live with chronic back pain. When you're in crippling pain and it's putting a stopper on your lifestyle, say yes to painkillers.

Backache blighting your life? Pain killing your enjoyment? Then do a little pain-killing yourself courtesy of the chemist.

WHAT DRUGS ARE OUT THERE?

Not all painkillers are the same, and it's important to know what's out there, and what they'll do for you and to you.

Paracetamol sounds boring - everyone has some somewhere in the house - but it really is one of the best types of medication for back pain. If it doesn't work for you, it could be because your back pain is just too severe. On the other hand, you might not be taking enough, or expecting it to cure rather than relieve your pain. So try taking eight 500 mg tablets spread out over 24 hours, unless you're taking other prescribed medication that would clash with paracetamol or already contains it. Side effects of paracetamol are rare, and pain relief lasts for 4-6 hours. Stock up with paracetamol from the supermarket or your pharmacist.

Another drug you can buy easily is ibuprofen, which is classed as a non-steroidal anti-inflammatory drug. Taken at regular intervals (e.g. 200 mg three times a day), ibuprofen will relieve straightforward backache. Drugs like ibuprofen can cause stomach problems, such as indigestion, nausea, diarrhoea and even bleeding from a stomach ulcer, though this latter is uncommon. They may make problems with blood pressure or asthma worse in susceptible people. Ibuprofen is more effective than paracetamol for relieving back pain as it acts on the inflammation causing the problem as well relieving the pain. It may be cheaper to get a prescription for a bigger quantity of ibuprofen if you need a high dose (e.g. 600 mg three times a day) or take it over a long time. Take it with food to lessen the chances of you getting side effects.

If paracetamol is not strong enough to tackle your pain, your doctor might prescribe you stronger painkiller,s like codydramol or co-codamol. More powerful still are drugs like dihydrocodeine, which are long-distant relatives of opium. These opiate drugs have side effects such as constipation, and may even depress your breathing rate and cause drowsiness, confusion, nausea and vomiting or an itchy allergic rash.

Another tack is to try a muscle relaxant. If your back pain has arisen from muscle spasm, or you've got spasm as your body's reaction to your back pain, you might be prescribed a muscle relaxant such as baclofen or diazepam. They can be effective in reducing your acute back pain, but they do have drowsiness as a side effect. You also may develop dependency, even after courses as short as a week.

Antidepressants are prescribed for chronic low back pain, just as for other types of long-standing pain. Having pain over a long time can actually make you depressed, but anti-depressant drugs are used to relieve pain when other treatments have failed, even in people who are not depressed. Amitriptyline is used for pain relief at lower doses than those used in depression, e.g. 10-50 mg a day, but may still give you side effects such as a dry mouth, sleepiness and constipation.

Anticonvulsant drugs that are usually used for epilepsy can be prescribed by a doctor in similar doses to relieve pain as for controlling fits. Antidepressants will be tried first as they may cause fewer side effects than anticonvulsants.

If your local doctor can't relieve your pain sufficiently, they might send you to a pain clinic.

Another option instead of your doctor's pills is to buy glucosamine, which is available over the counter in a pharmacy or health food shop as it's classed as a complementary medicine. It can be taken as a tablet or as an injection into a muscle. It's used for arthritis, so if this is the cause of your back problems, it might be worth trying.


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