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Prescription drugs
Regardless of the cause of the pain, a doctor will probably recommend the self-treatment techniques described [back.treat.self]. In general, limiting both bed rest and pain medication for back pain has increasingly become the approach of choice among primary-care physicians--a preference supported by current research.
If over-the-counter medications do not relieve the pain or if they cause serious side effects, a doctor might prescribe an NSAID such as diflunisal (Dolobid) or meclofenamate (available in generic form). Other commonly prescribed drugs include celecoxib (Celebrex) and valdecoxib (Bextra), from the drug class called cyclooxygenase-2 inhibitors. These drugs are theorized to treat pain and inflammation as effectively as traditional NSAIDs but with fewer adverse gastrointestinal effects. Not all studies have shown cox-2 inhibitors to be safer for the stomach than other NSAIDs, however.
Studies have shown that muscle relaxants are an effective treatment for acute low back pain; the usefulness of muscle relaxants for chronic low back pain requires further study. Muscle relaxants appear to work by depressing the activity of nerves in the spinal cord and brain. A few studies suggest that a combination of a muscle relaxant and an NSAID may be more beneficial than a muscle relaxant alone. Despite the benefits of muscle relaxants, their use is controversial. For example, muscle relaxants frequently cause drowsiness. In addition, muscle relaxants are potentially addictive.
Potentially addicting drugs such as opiates (for example, morphine, codeine, or meperidine) should be used with great caution as a treatment for back pain and only after all else has failed. Controlled-release formulations of oxycodone and morphine (OxyContin and MS Contin, respectively) are often used by people who need opiates for more than a few days.
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