Opioids and Narcotics
It is possible that acetaminophen, NSAIDs, and muscle relaxers might not be enough to help alleviate your back pain. If your back pain is chronic and long lasting your doctor may suggest opioid or narcotic pain relievers.
These medications act on the pain receptors and nerve cells of the brain. Some opioids are milder and include Tylenol with codeine and Vicodin (acetaminophen and hydrocodone) while others are stronger and include morphine.
The most common side effects of opioid or narcotic pain relievers are:
- Drowsiness and/or a feeling of sedation
- Severe constipation
- Allergic reactions, including itching and hives
- Risk of addiction
Much like NSAIDs, corticosteroids help alleviate pain and bring down inflammation. Your doctor can prescribe corticosteroids in a pill form or via injections into your back.
Oral corticosteroids are generally prescribed in a tapering method over a short period of time.
They may also cause significant side effects, including:
- Elevated pressure in the eyes
- Fluid retention in the legs and swelling
- Elevated blood pressure
- Weight gain
- Problems with memory and mood
Injected corticosteroids may cause temporary side effects near the injection site. Other side effects include:
- Changes to skin color or texture
- Facial flushing
- High blood sugar
Your doctor will limit your injections to no more than four per year because of the high potential for side effects.
Corticosteroids may cause many side effects, including ones not listed, but they do help with inflammation and pain.
It is important to work with your doctor to find ways to minimize any of the above side effects.
Antidepressants seem to seem to work well for treating back pain but the pain relief mechanisms for these drugs are unknown. Researchers believe antidepressants increase pain reducing neurotransmitters in the spinal cord.
It may take a week or longer to get pain relief from an antidepressant. However, most people only experience moderate pain relief.
Side effects of these medications may include:
- Dry mouth
- Blurred vision
- Sleep problems
- Problems with urination
- Sexual problems
Anti-seizure medicines, including gabapentin, are used to treat seizures or epilepsy. They work by affecting the electric signals in the brain and are most effective in managing pain related to nerve damage.
These drugs may also help with long-term back pain and make it easier for you to work and manage daily activities.
Side effects of anti-seizure medications include:
- Weight gain or loss
- Upset stomach
- Loss of appetite
Do not stop taking anti-seizure medications suddenly or change the dose without first talking to your doctor.
Not every medication is going to work to treat your back pain. Talk to your doctor if a medicine doesn’t work for you.
It does take a trial and error approach to find a medication that does offer you pain relief.
As a final note, medication isn’t an effective to treatment alone for back pain. You should use it in conjunction with other treatments, including exercise, physical therapy, and heat and ice packs.