Pain Management / Ways to Relieve Back Pain 

Sleep Better:

When you have back pain, sleeping can be hard. A poor sleep position can also aggravate back pain. If you need to sleep on your back, slide a pillow under your knees. 

• Stick to a sleep schedule
• Being consistent reinforces your body's sleep-wake cycle.
• Long daytime naps can interfere with nighttime sleep. Regular physical activity can promote better sleep. Stress management might help. Good Posture

Pillow Posture and Finding The Right Pillow

Pillow posture, or choosing the right pillow to go with your preferred sleeping position, is also important. Stomach sleepers can even sleep without a pillow if it’s more comfortable.

Side sleepers: you need a thicker pillow than back sleepers do. Tips for good pillow posture. Medication From the Store. 

There are two kinds of over-the-counter pain relievers that frequently help with back pain: nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. Talk to your doctor before taking pain relievers. And don't expect medication alone to solve your pain problem. How should I store my medications?

If you store your medications in a pill organizer, label it with the medication name, dose, frequency, and expiration date.

Prescription Pain Relievers

Some people may need prescription/ medications to help with pain. Your doctor may also prescribe muscle relaxants to help ease painful muscle spasms.

TYPES (CLASSES) OF PAIN MEDICATIONS

Pain medications are drugs used to relieve discomfort associated with disease, injury, or surgery. Because the pain process is complex, there are many types and drug classifications of pain drugs that provide relief by acting through a variety of physiological mechanisms. Thus, effective medication for nerve pain will likely have a different mechanism of action than arthritis pain medication.

• Nonsteroidal anti-inflammatory drugs (NSAIDs) act on substances in the body that can cause inflammation, pain, and fever.
• Acetaminophen increases the body's pain threshold, but it has little effect on inflammation.
• Opioids, also known as narcotic analgesics, modify pain messages in the brain.
• Anti-anxiety drugs work on pain in three ways: they reduce anxiety, they relax muscles, and they help patients cope with discomfort.
• Some antidepressants, particularly tricyclics, may reduce pain transmission through the spinal cord.
• Some anticonvulsant drugs also relieve the pain of neuropathies, possibly by stabilizing nerve cells

FOR WHAT CONDITIONS ARE PAIN MEDICATIONS USED?

It's not surprising, then, that pain medications, also known as analgesics, are among the most commonly used drugs in the U.S. Different medications are used depending on the type of pain.

WHAT ARE THE STRONGEST PAIN MEDICATIONS?

Opioid analgesics, in general, are the strongest pain-relieving medications. 

WHAT ARE THE SIDE EFFECTS OF PAIN MEDICATIONS?

Acetaminophen : most users of acetaminophen experience few, if any, side effects.

Opioids: Opioid analgesics commonly cause drowsiness, dizziness, and respiratory depression. 

Patients can experience symptoms of opioid withdrawal if a straight opioid analgesic, such as morphine, is taken at the same time as an opioid agonist-antagonist drug.

 Muscle relaxants
Anti-anxiety drugs also carry the risk of sedation, particularly if combined with certain other medications (such as opioid analgesics) or alcohol.

Chest pain and heart-pounding are also possible.

Antidepressants, some of the antidepressants used for pain relief are the older tricyclics, dry mouth.

Other possible side effects include lower blood pressure.

A few of the newer antidepressants also reduce pain -- and with less risk of anticholinergic issues.

Side effects associated with the anticonvulsants used for pain management commonly disappear over time. In general, short-term and/or low-dose corticosteroid use results in few side effects. But taking corticosteroids long-term can result in severe side effects, including: Elevated blood pressure, Trouble sleeping

WHAT ARE THE WARNINGS/PRECAUTIONS WITH PAIN MEDICATIONS?

Operating a motor vehicle or machinery may be dangerous while using these pain medications because they can cause drowsiness. Most muscle relaxants cause drowsiness. Anxiolytics or anti-anxiety medications -- especially the benzodiazepine class -- may cause drowsiness. Some antidepressant medications may cause drowsiness. 

Examples of nonprescription pain medications include:

• Acetaminophen (Tylenol)
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Opioid analgesics
• Fentanyl transdermal patches (Duragesic)
• Antidepressants
• Fibromyalgia medication
• Muscle relaxants
• Antidepressant Medications

Even if you're not depressed, your doctor may prescribe antidepressant medications as part of the treatment for chronic low back pain. It's not clear how antidepressants help relieve chronic pain. Finding the right antidepressant

For example, if you have trouble sleeping, an antidepressant that's slightly sedating may be a good option.

Possible side effects. Side effects of antidepressants vary from one medication to another and from person to person. Bothersome side effects, such as dry mouth, weight gain or sexual side effects, can make it difficult to stick with treatment. Discuss possible major side effects with your doctor or pharmacist.

Also, if an antidepressant has been effective for your depression in the past, it may work well again.

Interaction with other medications. Some antidepressants can cause dangerous reactions when taken with other medications.

Some antidepressants may cause problems if you have certain mental or physical health conditions. 

Many types of antidepressant medications are available to treat depression, including: 

• A typical antidepressants. These medications don't fit neatly into any of the other antidepressant categories. Bupropion is one of the few antidepressants not frequently associated with sexual side effects.
• Tricyclic antidepressants. Tricyclic antidepressants — such as imipramine (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin and desipramine (Norpramin) — tend to cause more side effects than newer antidepressants. So tricyclic antidepressants generally aren't prescribed unless you've tried other antidepressants first without improvement.
• Other medications. Your doctor may recommend combining two antidepressants, or other medications may be added to an antidepressant to enhance antidepressant effects.

Making antidepressants work for you

If your medication doesn't seem to be working or is causing bothersome side effects, call your doctor before making any changes.

See if the side effects improve. Many antidepressants cause side effects that improve with time. Explore options if it doesn't work well. If you have bothersome side effects or no significant improvement in your symptoms after several weeks, talk to your doctor about changing the dose, trying a different antidepressant (switching), or adding a second antidepressant or another medication (augmentation). A medication combination may work better for you than a single antidepressant.

In many cases, combining an antidepressant with talk therapy (psychotherapy) is more effective than taking an antidepressant alone. Some antidepressants can cause significant withdrawal-like symptoms unless you slowly taper off your dose. Avoid alcohol and recreational drugs. Talk with your doctor or therapist if you need help with alcohol or drug problems.

Physical Therapy

Doctors used to prescribe bed rest for back pain. Ice and Heat

Apply a heating pad or warm pack to help relax your muscles and increase blood flowing to the affected area. To avoid burns and tissue damage, never sleep on a heating pad.

Heat therapy And How it works

Heat therapy can relax and soothe muscles and heal damaged tissue.

Types

There are two different types of heat therapy: dry heat and moist heat.

• Dry heat (or “conducted heat therapy”) includes sources like heating pads, dry heating packs, and even saunas. 
• Moist heat (or “convection heat”) includes sources like steamed towels, moist heating packs, or hot baths. Professional heat therapy treatments can also be applied. Heat from an ultrasound, for example, can be used to help pain in tendonitis.

When applying heat therapy, you can choose to use local, regional, or whole body treatment. Local therapy is best for small areas of pain, like one stiff muscle. If you have either heart disease or hypertension, ask your doctor before using heat therapy. Applying heat therapy

Moderate to severe pain can benefit from longer sessions of heat therapy like warm bath, lasting between 30 minutes and two hours.

Cold therapy And How it works

It can temporarily reduce nerve activity, which can also relieve pain.

Types

Treatment options include:

• ice baths
• whole-body cold therapy chambers
• Cold therapy should not be used if you have poor circulation.

Applying cold therapy

Use cold therapy for short periods of time, several times a day. 

Risks of heat therapy

Heat therapy should utilize “warm” temperatures instead of “hot” ones. If you have an infection and use heat therapy, there is a chance that the heat therapy could increase the risk of the infection spreading. If you experience increased swelling, stop the treatment immediately.

If heat therapy hasn’t helped lessen any pain or discomfort after a week, or the pain increases within a few days, make an appointment to see your doctor.

Risks of cold therapy

If you’re not careful, cold therapy applied for too long or too directly can result in skin, tissue, or nerve damage.

If you have cardiovascular or heart disease, consult your doctor before using cold therapy, If cold therapy hasn’t helped an injury or swelling within 48 hours, call your doctor.

Hands-On Therapy

A recent study found that one weekly massage over a 10 week period improved pain and functioning for people with chronic back pain. Nerve Stimulation

Research is being conducted on certain treatments that stimulate nerves to reduce chronic back pain. 

Talk Therapy

Some studies have found that it is better than medication in easing back pain, reducing pain intensity by about 30%. The best part: it has no side effects.

Spinal Injections

A doctor may recommend a spinal injection to help reduce your back pain. There are different types of injections that doctors specializing in pain relief may use. For example, an injection of a corticosteroid can help relieve inflammation that is causing the pain. Back Surgery Spinal fusion may be done to help stabilize the spine. You don't need to take as much pain medicine.

Spinal fusion. Laminectomy. This relieves pressure on spinal nerves and can ease pain or weakness, but the procedure can make your spine less stable. This surgery is used to relieve pain associated with a compressed nerve in the spine. The extra room may relieve pressure on the nerves and ease your pain. 

The biggest risk of back surgery: Not knowing for sure if it’s going to help with your pain. 

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