It’s easy to forget sometimes that over-the-counter medications like panadol and ibuprofen are actually very effective in controlling pain.
- Ibuprofen – anti-inflammatory medications (NSAIDs) like nurofen are highly recommended for back pain. In most cases, your pain is a result of irritation and inflammation affecting the nerves. By reducing the inflammation and swelling, ibuprofen not only relieves your symptoms but helps speed recovery.
- Paracetamol – low doses of paracetamol can be taken over the day (always remain under the prescribed doses) to help reduce the background of pain. While paracetamol may not relieve the pain totally, it can help you get out of bed and get to work.
You can discuss these with your pharmacist and carefully read the label to make sure you are taking these drugs appropriately.
If these medications do not work, you should see your GP. Your doctor can refer you on to other healthcare professionals in your area as well as prescribe other pain medications.
Opioid Analgesics | Eg. Panadeine, Oxycodone
Opioids should generally be avoided in back pain because they do not cure the cause of pain and tend to be used for long periods of time.
Panadol or Anti-inflammatories combined with weak opioid medications, like panadeine, are however useful in short courses for more severe back pain. These drugs can also be addictive so it’s important you only take these when needed, and do not use for more than short periods of time (days-weeks, not months).
Muscle relaxants | Eg. Tramadol
Usually, muscle relaxants are only used when simple over the counter medications have been tried for some time and have failed to control pain.
These drugs can be very effective at limiting the course of back pain as well as reducing pain. However, they only work in specific situations. In addition, muscle relaxants should not be used for long periods of time, as they can be addictive and have serious side effects in prolonged use.
Anti-depressants | Tricyclics, SSRIs
A particular class of anti-depressants, the tricyclics, are used to control pain because they affect the way nerves sense and carry pain.
Other anti-depressants are used in back pain when depression develops. This is often a result of the pain and dysfunction rather than a cause of back pain.
Treating symptoms of depression and anxiety is a key component of a holistic treatment of back pain, recognising that pain, especially chronic pain, is an emotional as well as a physical experience.
References
Waddell, G., ‘The Back Pain Revolution’, 2nd Ed., Churchill Livingstone, Elsevier Ltd., UK, 2004.