Low back pain is a major cause of medical treatment, disability and job loss. Not all low back pain is due to an auto accident or a worker’s compensation injury or condition; in fact almost 25% of American adults are estimated to have experienced low back pain within the last three months. Regardless of cause, pain medication is often part of managing chronic low back pain, and the medications fall into five general categories:
Generic paracetamol or acetaminophen, brand name Tylenol, is classified as a mild analgesic used to relieve pain, but is has little or no effect on any underlying inflammation as it is not an anti-inflammatory. It blocks transmission of pain in the central nervous system.
Aspirin, ibuprofen and naproxen are nonsteroidal anti-inflammatory drugs that provide analgesic and, in higher doses, anti-inflammatory effects to help relieve pain. Prostaglandins are a family of chemicals that are produced by the cells of the body and promote inflammation that is necessary for healing, but also results in pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) block certain enzymes and reduce prostaglandins throughout the body. As a consequence, ongoing inflammation, pain, and fever are reduced.
Tricyclic antidepressants, such as amitriptyline or doxepin, are used at times to treat low back pain. The painkilling mechanism is unclear but may involve increasing neurotransmitters in the spinal cord that reduce pain signals.
A muscle relaxant is a drug which affects skeletal muscle function and decreases muscle tone. It may be used to alleviate symptoms such as muscle spasms and pain. Muscle relaxants operate as neuromuscular blockers by stopping the transmission of the pain. Examples include soma, flexeril, and diazepam and valium.
Opioid analgesics suppress one’s perception of pain and calm the emotional response to pain by reducing the number of pain signals sent by the nervous system and the brain’s reaction to those pain signals. Generic examples are fentanyl, hydrocodone morphine, and oxycodone; brand name examples are Duragesic, Norco, OxyContin and Vicodin, and Percocet. Like other drugs, opioids have side effects, as well as tolerance and overuse issues which must be monitored.
Personal injury or worker’s comp attorneys must be familiar with the types of pain medication their client’s are using. This general information is not to be taken as advice by any person to their particular circumstances. Every person should direct questions to their doctor and only take medical advice from a qualified health care professional.
