It's hard to find someone who hasn't had back pain at some point in their life, isn't it? For some, this is a constant problem. So, when this back pain comes, we all go to the pharmacy to buy medicine, or take a medicine prescribed by a doctor. But did you know that not all medicines for this back pain are the same, and their effectiveness and side effects are very different from each other? Today, let's talk about this.
Let's first look at Paracetamol (Acetaminophen).
Paracetamol is often the first medicine a doctor will prescribe for a backache. This is the type of medicine that we all know, such as Panadol. Simply put, it blocks pain signals from reaching our brain. However, it does not reduce inflammation in the body.
Compared to other painkillers, paracetamol is not as harsh on the stomach. So it's very useful for toothaches, headaches, and pain after surgery. But to be honest, there's not much evidence to show how effective it is for back pain. But the way it affects each person can vary. So even though research doesn't show great results, it might still help you.
Things to be careful of: Taking too much paracetamol can cause serious liver damage. That's why doctors advise not to take more than 3,000 milligrams (mg) per day. Although the maximum dose is 4,000 mg, it's best to stay within the safe range.
NSAIDs (such as aspirin and ibuprofen)
These are the other main types of painkillers that you can buy over the counter as an alternative to paracetamol. These are called Nonsteroidal anti-inflammatory drugs, or ``NSAIDs''. These drugs help reduce pain and also reduce swelling and fever . Drugs like Ibuprofen, Diclofenac, and Mefenamic Acid belong to this group.
Things to watch out for: These NSAIDs can cause digestive problems like nausea, stomach pain, and heartburn. Rarely, they can cause serious side effects like stomach ulcers and internal bleeding. They can also affect the kidneys and heart with long-term use. That's why it's important to talk to your doctor before using this medication.
Muscle Relaxants
Sometimes, if your back pain is caused by a sudden muscle spasm, your doctor may prescribe this type of medication. We call these muscle relaxants . These work by relaxing the tight muscles and reducing pain. Examples of these medications include Cyclobenzaprine and Tizanidine.
Things to be aware of: One of the main side effects of this medication is drowsiness and dizziness . Therefore, you should avoid doing tasks that require alertness, such as driving or operating machinery, while taking this medication.
| Type of medicine | Main functionality | Common side effects |
|---|---|---|
| Paracetamol (Acetaminophen) | Blocking pain signals. | Exceeding the dose can cause liver damage. |
| NSAIDs | Reducing pain and swelling. | Stomach problems, chest inflammation. Long-term risks of kidney and heart disease. |
| Muscle Relaxants | Relaxing tight muscles. | Severe drowsiness, dizziness. |
| Antidepressants | Controlling neuropathic pain. | Drowsiness, dizziness, dry mouth, constipation. |
| Opioids | Providing short-term relief from severe pain. | Nausea, constipation, drowsiness. Risk of addiction in the long term. |
Antidepressants for back pain?
Yes, you heard right. Sometimes antidepressants are also prescribed for back pain. This is not the case for all back pain. If your pain is neuropathic pain, which means it feels like an electric shock or a tingling sensation that travels down your leg , this medication may be helpful.
But you can't expect results right away after taking this medicine. It usually takes a few weeks before you start feeling some relief from the pain. Medicines like Amitriptyline and Nortriptyline are used in this way.
Things to be aware of: Side effects such as drowsiness, dizziness, dry mouth, and constipation may occur when taking this medication.
Remember, it can be very dangerous to take over-the-counter medications without properly diagnosing the cause of your back pain. Always seek the advice of a qualified doctor.
Opioids, powerful painkillers
These are the most powerful painkillers . Drugs like Tramadol belong to this group. Doctors sometimes prescribe these drugs for severe back pain. But new research has shown that these only provide short-term relief .
And the risks are high. Because of hormonal changes and the risk of drug dependence, doctors rarely recommend these for chronic pain. Even when they are recommended, they are given in conjunction with other treatments, such as exercise and lifestyle changes. Also, your doctor will check you regularly to make sure that these medications are not causing you any harm, are reducing your pain, and are increasing your ability to perform daily activities.
Things to watch out for: Short-term side effects like nausea and constipation may occur. Long-term use can also lead to conditions like depression and sexual dysfunction.
Take-Home Message
- Don't use any medicine for back pain without consulting your doctor. The most important thing is to find out the exact cause and treat it.
- Not all painkillers are the same. They have different mechanisms of action and side effects.
- Never exceed the recommended dosage, especially for medicines like paracetamol. This can cause serious liver damage.
- Be sure to tell your doctor about any other medical conditions you have (e.g. gastritis, kidney disease, heart disease) and any other medications you are taking.
- Often, medication is only one part of the treatment. Proper exercise, maintaining posture, and lifestyle changes are also essential for a healthy spine.
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