Back injuries are sometimes treated with medications and the patient does not always fully understand what he is taking. In general, we should not take anything we do not need and for that it is important to have information. I will comment on each type of medicine in general, and then I will make a reflection so that we understand them together.
– Anti – inflammatory: They are drugs that lower inflammation and decrease pain. They can be harmful in people with problems of stomach, of kidney or with hypertension or problems of heart. Sometimes our doctor will advise us to accompany him with a protective medicine for the stomach. This type of medication is not recommended to take more than one or two weeks in a row because they hurt us, although sometimes our doctor can prolong it.
When we talk about anti-inflammatories we refer to the so-called NSAIDs (non-steroidal anti-inflammatory drugs). This is because the most potent anti-inflammatory drugs are corticoids but they are very different drugs.
– Analgesics: They are drugs that act to decrease pain. These drugs are the safest to take on an ongoing basis. The most common are paracetamol and metamizole (nolotil). These are the ones we are going to take with mild or moderate pain. When the pain is more intense use more potent drugs, which are the opiates, which we will see later.
– Muscle relaxants: They will relax the muscles and we will reduce the anxiety component that accompanies the pain. They can also help us rest better at night. The most commonly used are benzodiazepines. These medications are also not recommended for more than 7-10 days because they will not have the same effect and we will get used to taking them to sleep.
– Corticosteroids: They are the most powerful anti-inflammatories. They can be used in tablets although it is very frequent the use in injections as it is the case of the Inzitan. These drugs are those used in infiltrations.
– Opiates: In this family of analgesics we have the so-called minor and major opiates. Minors are substances such as tramadol (which act poorly on opioid receptors) that have less potency than older ones but may have more effect on neuropathic pains (those caused by nerve damage). The major opiates are the relatives of morphine and are the most potent analgesics available; however they are not the best for neuropathic pain.
– Antiepileptics: Medications such as pregabalin (Lyrica) or gabapentin have become well known in recent years. The reality is that they are not used for epilepsy. Their role as analgesics in neuropathic pain was discovered. It is used in pains such as sciatica where there is a nerve injury that generates unpleasant sensations.
– Antidepressants: They are sometimes used because they can improve pain control. In neuropathic pain the most used is amitriptyline.
In an acute phase, when we just hurt, the most frequent is that we send the first three paragraphs we have discussed (anti-inflammatories, analgesics and muscle relaxants). It is necessary to be clear that these medicines do not cure anything; they are alleviating the symptoms and allow us to better cope the moments of more pain. Anti-inflammatories and pain relievers relieve pain and inflammation, while muscle relaxants improve muscle soreness and help us rest better at night. We have said that they are not curative but there is an exception, which are steroids. In cases where there is a hernia that is compressing a nerve root can have a curative effect. Being potent anti-inflammatories can cause the root to regain enough space to not be damaged and improve the situation significantly. Corticosteroids are complex and have contraindications so they have to be handled by the doctor. In addition, the doses and the type of corticosteroid used may vary according to the situation.
As you can see the medication is an aid but the one that will cure the injury is our organism and we must do our best to help. When we have a wound on the skin, does it crust and heal itself, right? Well, the back is the same. The wound only has to be cleaned so that it does not become infected and not manipulated so that it can heal. In the back we have to avoid attitudes, postures and harmful efforts to let our body heal the injury.