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Handout #2 - Using Medications Effectively Medications are often recommended to reduce the swelling and pain that accompanies low back pain. Your health care provider will tell you what medications are appropriate for your injury -make sure you understand what medication(s) you are to take, how often, and for how long (number of days). If you are not clear on this information, call your health care provider's office and follow up by asking any questions that you have.Both prescription and over-the-counter medications are used to treat low back pain. Sometimes medications can interact with each other or with alcohol, so make sure your health care provider and pharmacist know what medications you regularly take. If you are taking a new prescription, be sure to read the instructions that come in the package and inform you of any precautions specific to that medication. Common types of medication used to treat low back pain include: Acetaminophen (also known as Tylenol, Anacin Aspirin-Free, Non-Aspirin) alleviates low back pain with few side effects, when taken at regular intervals. Regular intervals means every 4 to 6 hours as prescribed by the treating provider, not just when pain is noted. This medication is not recommended for persons who have three or greater drinks a day. One drink is equal to 12 ounces of beer, a 6 ounce glass of wine, or a mixed drink (usually contains 1-2 ounces of liquor). Make sure you let your health care provider know if you normally have three or more drinks a day and they will recommend another type of pain medication for you. Aspirin (and medications containing aspirin such as Excedrin) and ibuprofen (also known as Advil and Motrin) reduce the swelling and pain that accompanies low back pain. Sometimes these medications are to be taken only when you have pain -in other situations, you may be told to take medication three or four times a day, regardless of whether or not you are in pain at that time. Occasionally these medications cause an upset stomach or heartburn-call your health care provider if you experience these problems and ask to have a different type of medication recommended for you.Non-steroidal anti-inflammatory drugs Non-steroidal anti-inflamatory drugs (ketoprofen, naproxen) are medications that reduce both pain and swelling -they are similar to aspirin, but may be stronger or last for a longer period of time. These medications are commonly used to treat low back pain because they are very effective and have minimal side effects. Like aspirin, they can occasionally cause stomach distress. As above, if you have a history of stomach problems (such as ulcers, a hiatal hernia, or severe heartburn) or experience new symptoms when you are taking these medications, call your health care provider and ask for a different medication.Muscle relaxants (Flexeril, Soma) can effectively reduce acute LBP but have a high risk of drowsiness and potential physical dependence. There are definite trade-offs that your health care provider will consider in deciding to prescribe this type of medication for you. Up to 30% of persons taking these medications experience drowsiness or dizziness; sometimes these side effects can be serious enough to inhibit one 's ability to drive or operate machinery. If you take muscle relaxant medications, try to maintain your usual day and night sleep pattern. Long daytime naps can easily lead to nighttime insomnia and the development of a sleep disturbance-work to stay alert during your usual alert time so you sleep well and become rested as you recover.Opioid medications (Darvocet, Percocet) may be used if previous drugs are inadequate, but can cause constipation and drowsiness; in addition they can be associated with an inability to concentrate. Strong opioids have not been shown to be more effective in relieving LBP than the safer analgesics mentioned previously. Although opioid medications can be effective in reducing severe pain, it is possible to develop a physical dependence (addiction) to these medications. Because of this risk, it is very important that you take the medication only for the number of days noted by your health care provider. Do not exceed this time period for any reason. Antidepressants (Sinequan, Prozac, Zoloft, Wellbutrin) are useful in treating chronic low back pain (lasting more than three months) but have not been shown effective in treating acute LBP. If you think you have symptoms of clinical depression, discuss these concerns with your health care provider, so they can make an appropriate recommendation for you. This is very important because untreated depression can make it more difficult to have the energy to develop a sound recovery plan for chronic low back pain. Common symptoms of clinical depression include: insomnia (inadequate sleep) or sleeping too much, severe lack of energy, extreme sadness and apathy (feeling unable to care about anything), under- or over-eating, and feeling overwhelmed with daily activities. General Guidelines for Taking Medication for Low Back Pain When you leave your health care provider 's office, make sure you understand exactly how (how many pills, how many times a day, and for how many days) your are to take these medications.Prescription medications are ordered specifically for your injury and body size. They are for you alone and not to be given to anyone else for any reason. Store your medications in a safe place in your home that cannot be accessed by small children.
For information contact rtw_project@montana.edu, Dr. Patricia Butterfield, Montana State University-Bozeman. Do not copy without permission.
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