Medical Treatment

Medical Treatment of Back Pain

Medical doctors have many types of possible treatments for back pain. Here are a few of them:

1. Prescription Medications /Anti-inflammatory Drugs

2. Surgical Procedures that Fix the Problem

3. Surgical Procedures that Stop the Pain

Prescription Medications / Anti-Inflammatory Drugs

Non-steroidal anti-inflammatory (NSAID) drug are often prescribed along with a muscle relaxant for back pain. NSAIDs can begin to decrease the inflammation so that healing can start. This can be very helpful in the case of muslce strains and sprains.

Some examples of commonly used NSAIDs include:

• aspirin                       • ibuprofen                   • ketoprofen                    • Celebrex

• naproxen                   • piroxicam                  • meloxicam                    • toradol

NSAIDs interfere with the action of an enzyme called cyclooxygenase (COX) in the body. This enzyme converts one of the fats you get in your diet, arachidonic acid, to chemicals called prostaglandins. The prostaglandins cause inflammation in the body; thus, by inhibiting them, pain relief is felt.

Muscle relaxants will force the muscles to relax which can remove some of the pressure on nerves from tight muscles. Some examples include the following:

• methocarbamol         • cyclobenaprine

• diazepam                     • tizanidine (for headaches)

• clonidine                     • baclofen

 

Treatment with NSAIDs and muscle relaxants are a standard initial approach to acute back pain, and are effective for most people when combined with a reasonable home exercise program.

Side Effects of NSAIDs and Muscle Relaxants

One thing to remember about NSAIDs and muscle relaxants is that they are not meant for long-term usage. Both types of medication have side effects associated with them.

Here’s a list of what to watch for:

• Ulcers of the stomach lining, causing internal bleeding

• Kidney damage

• Nausea and vomiting

• Heartburn

• Swelling of the feet/ankles

• Muscle pain / weakness

• Bruising / bleeding

• Abdominal pain

• Dizziness

• Drowsiness

• Diarrhea / constipation

• Allergic reaction

• Heart failure

• Confusion

• Dry mouth

• Blurred Vision

• Fatigue

• Difficulty urinating

• Lack of appetite

• Seizures

• Loss of coordination

• And more!

While no one medication has all of these side effects and most patients do not have any of these side effects, be sure to talk to your doctor before taking any medications.

Surgical Procedures that Decrease the Pain

Medical doctors can also perform surgeries where painkillers are injected into the spine in the area that is causing the back pain. These injections have done wonders for many patients, especially those with intractable pain.

Surgical Procedures that Fix the Problem

Spinal fusion is one of the primary surgical procedures that is performed for back pain, fractures, scoliosis (Link to scoliosis page), and spondylolisthesis (Link to spondylolisthesis page). The procedure may also be used in cases where an infection has eaten away parts of the vertebrae and the vertebrae is no longer able to support itself.

In spinal fusion surgery, actually two surgeries may need to be done:

  1. Bone fragments are removed from the pelvis bone
  2.  The actual spinal fusion

The bone fragments help the area heal in time and prevent the motions that cause back pain. Both surgeries are quite painful.

Spinal Fusion for Herniated Disc

In the spinal fusion surgery for herniated disc, the herniated disc is removed first. Then bone fragments are added to the herniated disc area, which will start to fuse the vertebrae together, forming one bone. Titanium screws, strips or rods may hold the vertebrae together for support during the bone growth period.

This type of surgery depends on a lot of assumptions that things will go right, such as:

• The bone from the hip will grow the bone without complications

• Enough space will be left between the two vertebrae

• The motion of the rest of the spine will be intact.

• The patient’s pain will be reduced.

The rehabilitation time can be quite long and the person will have restricted motion in the spine for life, especially if he has had multiple fusions in the spine.

New Medical Ideas Replacing Spinal Fusion

Luckily, medical science has progressed rapidly in the last decade. Although spinal fusion is still performed for disc herniations and some cases of pinched nerves, there is no lack of innovative doctors trying to perfect better techniques.

For example, using a genetically engineered protein, doctors can create a new disc. Here’s how the procedure is done:

  1. First a sponge made from collagen is soaked with bone proteins and sterile water.
  2. The sponge is then inserted inside a titanium cage that resembles a vertebrae
  3. New bone then grows on the sponge and fills the space of the cage. The process takes about five months.

What a pretty incredible idea! And so far, doctors are liking this new surgical procedure because they see that it can immediately make a patient feel better. The titanium cage allows separation of the two vertebrae that have collapsed on top of each other, which has created all the back pain symptoms in the first place. The new bone grows and the patient feels like he’s brand new. This is generally considered an experimental treatment and is not widely available.