Many Pain Medications Can Be Used for Spine-related Pain in Older Adults (2024)

FAQs

Many Pain Medications Can Be Used for Spine-related Pain in Older Adults? ›

Rational therapeutic choices based on geriatric spine pain diagnosis are helpful, such as NSAIDs and acetaminophen for arthritic and myofascial-based pain, gabapentinoids or duloxetine for neuropathic and radicular pain, antispastic agents for myofascial-based pain, and combination therapy for mixed etiologies.

NSAIDs. NSAIDs are often the go-to drugs for back pain relief. They can be purchased over the counter (or, in higher doses, by prescription) and include ibuprofen (Advil) and naproxen (Aleve). NSAIDs help reduce pain, swelling, and inflammation in muscles and around damaged spinal discs or arthritic joints.

Current guidelines promote paracetamol as the first-line analgesic for acute pain in older adults, whereas opioids are advised cautiously for moderate to severe acute pain. However, opioids come with a significant array of side effects, which can be more pronounced in older individuals.

In addition, frequently reassess and re-dose as needed to avoid undertreatment of pain while monitoring for adverse effects. Consider morphine (0.05-0.1 mg/kg IV or 4-6 mg fixed-dose PO) as first-line opioid analgesia for older adults in moderate to severe pain unresponsive to non-opioid oral analgesics.

If your pain continues, your provider may suggest nonsteroidal anti-inflammatory drugs (NSAIDs). You can buy some NSAIDs, such as ibuprofen and naproxen, without a prescription. NSAIDs help reduce the swelling around the swollen disk or arthritis in the back.

Acetaminophen (Tylenol) is usually safer for older adults than other pain medicines. Topical pain medicines (also called topical analgesics) can also help.

Your doctor may also prescribe a medicine called an opioid for lower back pain. Weak opioids (such as codeine) may be given for moderate pain. For severe and persistent pain, you may need stronger opioids, such as morphine. You might have this with or without paracetamol.

Additionally, nerve pain medications (gabapentin and pregabalin) can be used in older persons, with caution to dose and kidney function. Newer antidepressants (duloxetine) more so than older ones (nortriptyline) can help with spine-related pain, with attention to possible sedation and dizziness.

Anticonvulsants are one of the most effective medications for treating nerve pain. Examples include pregabalin (Lyrica) and gabapentin (Neurontin). These medications are typically very effective in treating nerve pain, but they may also cause undesired side effects, such as: lethargy.

Which painkiller is best for long-term use? ›

Acetaminophen is generally a safe option to try first for many types of pain, including chronic pain. Ask your health care provider for guidance about other medications to avoid while taking acetaminophen.

Endorphins are the body's natural painkillers. Released by the hypothalamus and pituitary gland in response to pain or stress, this group of peptide hormones both relieves pain and creates a general feeling of well-being. The name of these hormones comes from the term "endogenous morphine."

Acupuncture, massage, biofeedback therapy, laser therapy, electrical nerve stimulation and other nonsurgical spine treatments can make a difference for chronic back pain. Overall, the potential benefits of these strategies far outweigh their potential risks, so they are worth exploring.

If your back pain is severe or not getting better, a GP may prescribe painkillers or medicines to relax the muscles in your back. Other treatments may be recommended if your pain does not get better after a few weeks. These include: group exercise sessions and physiotherapy.

Chlorzoxazone and Ibuprofen for Lumbar Spinal Stenosis: A 2019 study in Pain and Therapy highlighted the effectiveness of chlorzoxazone and ibuprofen together over ibuprofen alone for acute low back pain.

Best for fast back pain relief: Ibuprofen (Advil, Motrin)

Ibuprofen (Advil, Motrin) is an NSAID. NSAIDs work by decreasing pain and inflammation. Ibuprofen is available as branded medication and as a lower-cost generic.

The Geriatric Lexi-Drugs database recommends the avoidance of muscle relaxants other than diazepam and tizanidine in patients older than age 65 years because efficacy and safety have not been established in geriatric patients.