What is back pain?
Back pain is extremely common and occurs when there is a problem associated with your spine.
Your spine is a column of bones. These bones are cushioned from each other by shock-absorbing disks, and the spine itself is held together by various ligaments, tendons and muscles.
Most back pain, even severe back pain, is not serious and if you are under the age of 60, will improve significantly or go away within six weeks
Often, it’s hard to definitively say what has caused back pain in individuals, but it is usually related to one or more of the following:
- Muscle or ligament strain. Lifting heavy things or a sudden awkward movement can strain muscles and ligaments, or cause painful muscle spasms
- Bulging or ruptured disks. Disks act as cushions between the bones in the spine. The soft material inside a disk can bulge or rupture and press on a nerve. Disk disease can also sometimes be discovered on X-rays, CT scans or MRIs
- Arthritis. Osteoarthritis can affect the lower back
- Osteoporosis. The spine’s bones or vertebrae can break if bones become porous and brittle due to osteoporosis
Common back pain symptoms include the following:
- Pain or stiffness in your back
- Limited movement in your back
- Moving your back causes or increases pain in your back
- Your back pain may spread to your buttocks or legs
- You may feel pins and needles, or numbness in one of your legs or feet
How to treat without medication?
- Move your back. Gentle movements help reduce pain and spasm, and also help with healing
- Exercise. Exercise can help reduce pain and prevent further episodes occurring, but only exercise if the discomfort feels manageable and your pain does not get worse.
- Apply gentle heat or ice. Applying a warm wheat bag, or a cold bag of frozen vegetables can both offer relief
- Physiotherapy. A physiotherapist can give you exercises to do at home that can help reduce pain and prevent further episodes occurring
- Other treatments. Other treatment options to consider that can help manage back pain are: acupuncture, back manipulation and massage
What medications can I take for back pain?
Medication can be used to supplement moving your back, gentle heat or ice treatment, physiotherapy, or other treatments.
If you use pain relief medication, always take as directed on the label or as instructed by your healthcare provider. Back pain medication is usually best taken on a regular basis for 3 to 5 days, versus only using it intermittently when your pain becomes unbearable.
Simple pain relief for back pain
Over-the-counter pain relief can help with the management of symptoms of back pain.
Paracetamol. Acts on pain pathways in the brain and is good for mild pain, or in combination with other medications for more severe pain. Paracetamol examples include Panadol, Ethics Paracetamol, Paracare, Pharmacare Paracetamol, Apo-Osteo, Panadol Back & Neck, Panadol Osteo P, Paracetamol Osteo-Tab.
Non-steroidal anti-inflammatory drugs (NSAIDs). Reduce muscular or arthritic inflammatory pain by blocking pain-inducing chemicals in the tissues causing them to swell and create pain.
Simple NSAID examples include ibuprofen (Brufen, Ibugesic, I-Profen, Nurofen, Advil, Fenapaid), naproxen (Noflam, Naprosyn), aspirin (Cartia, Heartcare Aspirin, Cardiprin, Aspec) and diclofenac (Voltaren).
- Naproxen lasts longer in the body; Ibuprofen is safer for your stomach and is also preferred in children ages 3 months to 12 years
- NSAIDs can help to ease acute back pain, but they have side effects and are not suitable for everyone
- Before taking NSAIDs, check with your pharmacist if they are suitable for you.
- NSAIDs are not suitable for chronic back pain because of the harmful effects associated with their ongoing use.
When to see a doctor
Make an appointment to see your doctor If you have any of these symptoms:
- Your back pain is not getting better after a few weeks of exercises and simple pain relief treatments
- You have pain in your lower leg as well as your back
- You have weakness and numbness in one of your legs
- You have a rash in the same area as your pain
See a doctor urgently if you have any of these ‘red flag’ symptoms:
- Numbness in your groin or buttocks
- Loss of bladder or bowel control
- Redness or swelling on your back
- Difficulty walking
- Constant pain, especially at night
- Pain that is getting much worse, or spreading up your spine
- Numbness or pins and needles in both legs
- Feeling unwell with your back pain eg fever, night sweats
GP prescription pain relief for back pain
Newer NSAIDs. include the more specialised COX 2 inhibitors, such as Celebrex (celecoxib) and Arcoxia (etoricoxib) and are prescription only.
Narcotics or opiates. Affect the way the brain interprets pain. Examples include codeine, morphine, tramadol and oxycodone.
- Used for severe pain either alone or in combination with other drugs
- Opioids are not recommended for routine use as the benefits are usually small compared to the risks
- Short-term use of opioids may be considered for some people with acute back pain
- Not recommended for chronic back pain because they have harmful side effects when used on an ongoing basis
Muscle relaxants. Example includes orphenadrine (Norflex). May be helpful when pain is related to muscle spasms but has harmful side effects when used on an ongoing basis
- Lower Back Pain: 7 Important (and Surprising!) Things to Know – ZOOM Pharmacy
- Back Pain – Health Navigator NZ
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