2016. Global Burden of Disease Study. Lower back pain is referred to as “acute” when the symptoms last for between one and twelve weeks. They are also referred to as “chronic” is when pain persists for three months or more.
Many people turn to an over-the-counter pain medicine to relieve. But what kind of pain medicine is the most efficient?
A study that was published on Wednesday in Journal of Orthopaedic Research, set out to discover. Researchers looked through the mountains of research studies published and discovered 18 clinical trials that were randomized and specifically focused on lower back pain lasting less than twelve weeks.
The study examined the different types of analgesics: aspirin, acetaminophen (Tylenol, Paracetamol and Panadol) as well as nonsteroidal anti-inflammatory medicines, known as NSAIDs in short that are numerous.
The most commonly used NSAIDs include ibuprofen (Advil, Motrin, PediaCare) and naproxen (Aleve, Naxen, Naprosyn, Stirlescent); and celecoxib (Celebrex Elyxyb, Celebrex) and is not sold over the counter.
Researchers also used muscle relaxers in the study, that aren’t available without prescription.
The study revealed that the best treatment that could be used for the treatment of chronic lower back pain was the combination of an NSAID coupled with an NSAID and a muscle relaxer prescribed by a doctorthe combination was efficient in reducing disability and pain at the end of a week.
But, these relaxers don’t function in the same way you’d think, explained the doctor. Eliana Cardozo, assistant professor of rehabilitation medicine in the department of rehabilitation medicineat the Icahn School for Medicine located at Mount Sinai in New York City.
“They do not go to muscles to relax them. Instead, they function in the central part of our brains that makes us sleepy, which helps to relax our bodies,” Cardozo, who was not part of the study, explained.
“It’s difficult to take them in the daytime for discomfort,” she added. “Personally I prefer using the muscle relaxers for those who are experiencing discomfort in the evening.”
Mixing NSAID with acetaminophen was linked with better results than using an NSAID by itself as the study showed.
“But when I looked over the actual results of the study, I’m unable to claim that it made enough of an impact to include the two medications as it was an extremely small benefit,” Cardozo declared.
Acetaminophen by itself does not significantly ease pain according to the study.
The findings of the study can only be applied to lower back discomfort that isn’t persistent and chronic, according to the study’s co-author Dr. Filippo Migliorini of the department of orthopedic, trauma and reconstructive surgery at The Universitatsklinikum Aachen located in Germany.
Before any intervention is suggested, the doctor must be certain to determine if there is a “possible particular cause of pain that might require specific diagnostics or actions like an underlying cancer diagnosis or recent trauma” Migliorini and his coauthors have written.
The side effects of pain medication
Another problem with pain medication is that they can cause potential for serious side consequences. Acetaminophen is not advised in pregnancy because it could cause hives, rash and breathing problems. The dosage is 4,000 milligrams, which can be consumed daily. A high dose can cause liver damage or even liver failure According to National Library of Medicine.
Some of the side effects of NSAIDs include indigestion , diarrhea, headaches, dizziness, allergic reactions and “in very rare instances, issues in your kidneys, liver or circulatory system, including heart failure as well as heart attacks and strokes,” the UK National Health Service stated.
Utilizing NSAIDs for a long time may cause stomach ulcers. These could cause internal bleeding as well as anemia according to the NHS advised.
“If one is well and doesn’t have any other health issues, it’s acceptable to take NSAIDs all around all hours of the day for a week but only for a week,” Cardozo said. “And If someone is suffering from asthma, high blood pressure or heart disease, or ulcer called a peptic ulcer, then they shouldn’t be taking NSAIDs continuously.”
Widespread problem
It’s estimated that 4 out of five people will suffer from low back discomfort in their lifetime in accordance with The Cleveland Clinic. Due to the ongoing degeneration of the spongy disks that connect back vertebrae, anyone who is older than 30 years old is more at risk of developing lower back pain.
Also, people who have excess weight due to an increase in joint pressure and discs, and smokers, those who consume a lot of alcohol or live a sedentary life according to the Cleveland Clinic. People with depression and anxiety have a higher risk of developing.
Patients who have had previously experienced episodes of acute lower back pain are more prone to chronic, ongoing symptoms according by the North American Spine Society.
Antidepressants aren’t recommended for treatment of lower back pain, as per the guidelines for clinical care developed by the society. The same is true for intravenous or oral steroids. “Opioid pain medication should be limited to a short time frame for treatment of lower back discomfort,” the guidelines state.
There are also over-the-counter creams that contain capsicum or chili peppers, are recommended as well as it is likely the spinal manipulative therapy can assist, but studies are inconsistent.
Exercise is strongly recommended: “Remaining active is preferred and will likely result more quickly as opposed to bed rest” the guidelines stated.
“People can begin some exercises immediately, including easy stretching exercises and core stabilizing exercisesthat will help strengthen back muscles. back,” Cardozo said. “Now these aren’t crunches or sit-ups — so consulting physical therapists to help with some exercises to start can be extremely beneficial.”
