Back pain medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Medical Therapy
- Medications, such as muscle relaxants,[1] narcotics, non-steroidal anti-inflammatory drugs (NSAIDs/NSAIAs)[2] or paracetamol (acetaminophen). However, a more recent randomized controlled trial found paracetamol no better than placebo.[3]
- If non-steroidal medications are inadequate, amitriptyline may be better than pregabalin for a second medication.[4]
- Tramadol does show benefit among registered randomized, controlled trials.[5]
- For injections, usually with corticosteroids, a meta-analysis of randomized controlled trials by the Cochrane Collaboration found no difference in long term out come regardless of whether the injection is facet joint, epidural or a local injection.[6]
- At least one study of intramuscular corticosteroids found no benefit.[7] Herbal analgesics may also be effective. It may very well be the case that steriods in and of themselves are not the answer as clinical improvement has been both reported and published numerous times with other injections (anesthetics, etc).
References
- ↑ van Tulder M, Touray T, Furlan A, Solway S, Bouter L. "Muscle relaxants for non-specific low back pain". Cochrane Database Syst Rev: CD004252. PMID 12804507.
- ↑ van Tulder M, Scholten R, Koes B, Deyo R. "Non-steroidal anti-inflammatory drugs for low back pain". Cochrane Database Syst Rev: CD000396. PMID 10796356.
- ↑ Williams, Christopher M (2014-07). "Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial". The Lancet. doi:10.1016/S0140-6736(14)60805-9. ISSN 0140-6736. Retrieved 2014-07-28. Unknown parameter
|coauthors=ignored (help); Check date values in:|date=(help) - ↑ Kalita J, Kohat AK, Misra UK, Bhoi SK (2014). "An open labeled randomized controlled trial of pregabalin versus amitriptyline in chronic low backache". J Neurol Sci. 342 (1–2): 127–32. doi:10.1016/j.jns.2014.05.002. PMID 24857356.
- ↑ GitHub Contributors. Back pain (chronic) treatment with tramadol: a living systematic review. GitHub. Available at https://github.com/openMetaAnalysis/back-pain-chronic-treatment-with-tramadol/. Accessed February 27, 2017.
- ↑ Nelemans P, de Bie R, de Vet H, Sturmans F. "Injection therapy for subacute and chronic benign low back pain". Cochrane Database Syst Rev: CD001824. PMID 10796449.
- ↑ Friedman B, Holden L, Esses D, Bijur P, Choi H, Solorzano C, Paternoster J, Gallagher E (2006). "Parenteral corticosteroids for Emergency Department patients with non-radicular low back pain". J Emerg Med. 31 (4): 365–70. PMID 17046475.