During the last 2 decades, there has been increasing focus on achieving adequate pain control, with the goal of quick and effective relief of pain. Using correlative data, others have linked prescriptions for opioids to overdose deaths and use of opioids in general to worse LBP outcomes.
However, opioids were not associated with higher rates of functional impairment, more frequent visits to the ED, or an increased propensity for continued opioid use. Our study has limitations. First, this study was conducted in an urban ED that served a socioeconomically depressed population. Because back pain outcomes may be associated with socioeconomic variables such as access to treatment, our results can most appropriately be generalized to EDs that serve similar patient populations.
Second, we reported a large number of related outcomes. This approach may lead to uncertainty with regard to interpretation of the data when some of the outcomes result in a statistically significant benefit and others do not. These latter findings must be interpreted cautiously because of the large number of analyses we performed.
Third, we did not evaluate the adequacy of patient blinding. These findings do not support the use of these additional medications in this setting.
Corresponding Author: Benjamin W. Author Contributions: Dr Friedman had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue.
View Large Download. Table 1. Baseline Characteristics. Table 2. Table 3. Table 4. Adverse Medication Effects a. Table 5. Three-Month Outcomes a. Supplement 1. Trial Protocol. Supplement 2. Additional Outcomes. Diagnostic testing and treatment of low back pain in United States emergency departments: a national perspective. Spine Phila Pa PubMed Google Scholar Crossref. Friedman BW, O'Mahony S, Mulvey L, et al One-week and 3-month outcomes after an emergency department visit for undifferentiated musculoskeletal low back pain.
Ann Emerg Med. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. Nonsteroidal anti-inflammatory drugs for low back pain: an updated Cochrane review. Muscle relaxants for nonspecific low back pain: a systematic review within the framework of the cochrane collaboration.
Medication use for low back pain in primary care. Low-dose cyclobenzaprine versus combination therapy with ibuprofen for acute neck or back pain with muscle spasm: a randomized trial. Curr Med Res Opin.
Berry H, Hutchinson DR. Tizanidine and ibuprofen in acute low-back pain: results of a double-blind multicentre study in general practice. J Int Med Res. PubMed Google Scholar. Basmajian JV. Acute back pain and spasm: a controlled multicenter trial of combined analgesic and antispasm agents. Cyclobenzaprine and naproxen versus naproxen alone in the treatment of acute low back pain and muscle spasm. Clin Ther. They can help if you have bad short-term pain —like pain after surgery for a broken bone.
They can also help you manage pain if you have an illness like cancer. But opioids are strong drugs. And usually they are not the best way to treat long-term pain, such as arthritis, low back pain, or frequent headaches. Overdosing on acetaminophen can cause severe damage to your liver. If you already have liver disease, ask your doctor if acetaminophen is OK for you to take. NSAIDs help reduce the swelling around the swollen disk or arthritis in the back. NSAIDs and acetaminophen in high doses, or if taken for a long time, can cause serious side effects.
Side effects include stomach pain, ulcers or bleeding, and kidney or liver damage. If side effects occur, stop taking the drug right away and tell your provider. If you are taking pain relievers for more than a week, tell your provider. You may need to be watched for side effects. Narcotics , also called opioid pain relievers, are used only for pain that is severe and is not helped by other types of painkillers.
They work well for short-term relief. Do not use them for more than 3 to 4 weeks unless instructed by your provider to do so. Narcotics work by binding to receptors in the brain, which blocks the feeling of pain.
These drugs can be abused and are habit-forming. They have been associated with accidental overdose and death. When used carefully and under a provider's direct care, they can be effective in reducing pain. Your provider may prescribe a medicine called a muscle relaxant. Practical Management of Pain. Philadelphia, PA: Elsevier Mosby; chap Updated by: C. Editorial team. Taking narcotics for back pain.
Names of Narcotics. Narcotics include: Codeine Fentanyl Duragesic. Comes as a patch that sticks to your skin. Taking Narcotics. Some important guidelines to follow while taking narcotics include: DO NOT share your narcotic medicine with anyone.
If you are seeing more than one provider, tell each one that you are taking narcotics for pain. Taking too much can cause an overdose or addiction. You should only get pain medicine from one physician. When your pain begins to lessen, talk with the provider you see for pain about switching to another kind of pain reliever. Store your narcotics safely.
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