Q:

Are Drugs are the most effective treatment for back pain?


A:

No one has all of the answers when it comes to treating back pain. Some people don't
fit the mold and traditional therapies don't seem to work.

Our experience with customers concerning pain medications or medications in general is
that they just don't want to have to take them. They want to get over what is causing
their pain and get on with their lives without the use of drugs. The most common concern
is about a drug causing stomach upset or nausea. Some customers have a concern about
the effects cortisone will have on their bodies, and others are concerned about the
addictive nature of the drug or the need for repeated use so that they can continue with
their normal activities.

Fortunately, the use of drug therapy is only temporary in a vast majority of people. Most
back pain cases will respond to the right combination of physical therapy and appropriate
biomechanical control with the use and/or surgery. A common drug used in the treatment
of back pain is an injectable steroid compound. These drugs are very effective in the
treatment of acute and chronic back pain. When used, these drugs should be used sparingly
and intermittently. At the dosages given to treat back pain they are very safe with minimal
risk of side effects or complications.

NASAIDS are more dangerous than people think. A new Baylor College of Medicine study shows
that NSAIDs may damage more of the intestine than previously thought. According to the study,
presented in May at the Digestive Disease Week 2003 conference in Orlando, 71 percent of
NSAID users had an injury in the small intestine compared to 5 percent of non-NSAID users.

“According to the images, patients who take NSAIDs regularly have an increased risk of
small intestinal mucosal ulceration and bleeding,”

One of the most common side effects of injectable cortisone, if given repeatedly in the same
location, is a shrinking of the soft tissue structures it is being injected into. Steroids will weaken
tendons if they are injected directly into the tendon and will thin cartilage on the surface of
joints when injected into the joint. Over time, the tissue will recover from these effects if the
drug is not used repeatedly over a short period of time. The rule of thumb is to not get more
than three injections into the same location over a twelve-month period and to wait at least
three weeks between injections. This of course depends on the dosage and strength of the
cortisone being used and the purpose for which it is being used.

The use of the drug can have side effects such as the shrinking of soft tissues in scarred and
damaged tissue. People who have diabetes should be warned in advance of using the drug that
their blood sugar levels might be temporarily elevated. Also, high dosages of cortisone given on
a prolonged basis can cause an elevation in the blood pressure, osteoporosis, stomach lining
irritation or ulceration and weight gain.

Another class of drugs commonly used in the treatment of back pain is the non-steroidal
anti-inflammatory drugs. These drugs can be used for long periods of time with relative safety.
However, a common side effect is stomach lining irritation. In some instances this can lead to
bleeding in the gastrointestinal tract. Because of the relative frequency with which these drugs
are used, a number of people can end up suffering from this complication and millions of health
care dollars are being spent to treat the side effects of these drugs. Fortunately, a new class
of drugs, is being developed that possess little to no side effects of this nature.

There are some promising new drugs on the market and drugs being investigated for the treatment
of pain. New drugs, which have the same potency for the control of pain without the addictive side
effects, are being developed. New modalities for blocking pain at the spinal level are becoming available
and being investigated. New imaging techniques, such as ultrasound, are being developed for back-related
problems, which show promise in the diagnosis of soft tissue injury that may be missed by x-ray, MRI, or
CAT scan.


























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