Medications for Spine Pain

ANTI-INFLAMMATORIES

STEROIDS (Medrol Dose Pack - Methylprednisolone)

Steroids are a powerful anti-inflammatory medication that blocks the chemical reaction that leads to inflammation (swelling, redness, pain) in the soft tissues and joints of the spine.


  • Take for 6 days only
  • DO NOT TAKE with non-steroidal anti-inflammatories, such as aspirin, ibuprofen, naproxen or diclofenac
  • Side effects are generally few with short term oral steroids and can include: stomach upset, headache, temporary weight gain, insomnia, and menstrual changes
  • Take your steroids WITH FOOD to minimize stomach upset
  • DO NOT TAKE if you have an active infection, such as a sinus or urinary tract infection
  • MAY increase your blood sugar if you are diabetic!
  • DO NOT TAKE if you are pregnant or breast-feeding


(NSAIDs) Non-Steroidal Anti-Inflammatory Drugs

These medications include: Ibuprofen, Naproxen, Celebrex, Voltaren (diclofenac), Lodine (etodolac), Feldene (piroxicam), Mobic (meloxicam)

  • DO NOT take these medications while you are taking steroids!
  • DO NOT take over-the-counter anti-inflammatories, such as Advil, Aleve or Aspirin in addition to prescription strength NSAIDS
  • NSAIDS work best if taken regularly
  • CAN upset your stomach if taken without food
  • MAY increase your risk of heart attack or stroke, although studies showed that the risk was increased with high dose, long-term usage
  • DO NOT TAKE if you have a history of gastric ulcer, intestinal bleeding, advanced kidney disease, or during pregnancy
  • If you have surgery, these medications need to be stopped 7 days before your procedure!


MUSCLE RELAXANTS

These medications include: Flexeril (cyclobenzaprine), Skelexin (metaxalone), Zanaflex (tizanidine), Robaxin (methocarbamol), Soma (carisoprodol)

  • This medicine treats moderate to severe muscle spasms
  • MAY cause drowsiness, as these medications are sedatives that work in the brain, it is recommended that you try it first at bedtime
  • CAN be habit-forming, if not taken as prescribed
  • If you are pregnant or nursing, you should consult your Obstetrician/Pediatrician before using muscle relaxants
  • DO NOT drive or operate heavy machinery while taking muscle relaxants
  • Alcohol MAY increase the effect of these medications, therefore you should not drink alcoholic beverages while taking muscle relaxers


PAIN RELIEVERS

TYLENOL (Acetaminophen)

  • An over-the counter pain-reliever (not an anti-inflammatory)
  • Can be taken in addition to NSAIDs (anti-inflammatories) or steroid medication
  • Two extra-strength Tylenol (1000mg total) should be taken every eight hours as needed for mild-to-moderate pain.
  • DO NOT take more than 1,000 mg of acetaminophen every eight hours, as higher doses provide no additional pain relief and can harm the liver
  • DO NOT exceed 3,000 mg in a 24-hour period


TRAMADOL (Ultram or Ultracet)

  • Is a non-narcotic pain reliever
  • You will not build up a tolerance to this drug
  • Very low incidence of addiction to this medication
  • Tramadol SHOULD NOT be taken if you are on anti-depressant medications as the combination of drugs can lead to seizures
  • DO NOT take with narcotics or alcohol
  • DO NOT take this medication if you are pregnant or breastfeeding
  • You MAY NOT take Tramadol if you have a history of seizures or epilepsy
  • Ultracet has acetaminophen in it, so do not exceed 4,000 mg of acetaminophen in a 24-hour period


NARCOTIC PAIN RELIEVERS

These medications include: Lortab (hydrocodone + acetaminophen) Percocet (oxycodone + acetaminophen)

  • Work in the brain to deaden the experience of pain
  • Should NOT be taken for minor aches and pains
  • SHOULD be taken only for severe pain
  • DO NOT take Tylenol in addition to your narcotics (most narcotics contain Tylenol)
  • CAN be addictive if used improperly
  • DO NOT drink alcohol if you are taking narcotics!
  • Take your medication AS PRESCRIBED. Notify the office if you are not getting any pain relief
  • If you are pregnant or nursing, consult your Obstetrician/Pediatrician before taking narcotics


ANTI-SIEZURE MEDICATIONS FOR NERVE PAIN - NEURONTIN (gabapentin) and LYRICA (pregabalin)


  • These medications are given to help minimize the pain caused from damaged nerves (neuropathic pain)
  • CAN be taken safely for prolonged periods of time
  • MAY cause drowsiness, dry mouth, constipation or confusion. These side effects usually go away within 1-2 weeks of starting the medication
  • You should NOT abruptly stop taking either Neurontin or Lyrica. These medications should be weaned off gradually. The ONLY exception to this rule, is if you are on Lyrica and experience blurred vision, you should stop the medication immediately!
  • Consult with your Obstetrician/Pediatrician if you are pregnant or breastfeeding, before taking these medications