The Best Medication for Chronic Low Back Pain

Thank you for the info.  It certainly would be interesting to see head-to-head trials of various medications rather than always comparing them to placebos, though I'm not sure where the funding would come from. 

Personally, I've found two complementary therapies more effective than medication for my low back pain – myofascial release therapy and acupuncture.  In fact, since starting those, I seldom have low back pain anymore unless I'm on my feet for a couple of hours straight.

I know this is a technical issue. But I would like to read this article but there isn't anything to read but Google adds.

When I tried to read the rest of the article all I got was some HTML code. Help! I really want to read this one.

Same here...I went to read the rest of this story and kept getting nothing but a blank screen.  I'm very intersted in this topic since I, too, suffer from disabling chronic back pain.  Does anyone know what I can do to read the rest of this article?

Why is it that although narcotics like  Vicodon are made to help people w/chronic sever pain, are starting to not be used by physicians.  I have a broken back and severe problems w/my hips, and am to have back surjery, but yet the Dr.s i've had are really reluctant (thier own personal beliefs) to perscribe them.  I have sufferd immensley (sp) because of it.  It's almost like Dr.s are starting to become (sadistic ?), they like causing patients pain and suffering.  I also had been put on methadone and it alterd my personality severly, and didn't work for the pain, and my Dr. not only refused to take me off and put me back on my vicodan, (which worked), but had the nerve to drop me and leave me hanging w/no dr. or clinic while on this severe drug that was messing w/my system. I had to take myself off of it, and sufferd with withdrawls (sp) untill i finally put myself back on and gradually took myself off of it. How can Dr.s get away w/that type of behavior as well? I'm tired of suffering at the hands of medical physicians, they are suppose to be helping us, NOT causing us more pain and suffering.

I have been unable to see the other comments to your Post so I hope I am not being repetitive. Thank  you for highlighting how difficult it is to find the appropriate medication and dosage for individuals in pain.  All pain is not alike, does not respond the same way, and most importantly each person can have a different reaction to the medication. This is frustrating for both the patient and the physician.

I have lived with pain since I was a young girl, over forty years now, and have been prescribed everything you mention in your Post and more. I have also had four major spine surgeries, has PT, spinal manipulation under anesthesia, steroid injections and epidurals, and the only treatment that has brought me any significant relief is the Intrathecal Morphine Pump that I had implanted in 2000.  A new one, with a larger reservoir which cut down how often I have to have it filled, was implanted in 2005, and continues to bring me relief.  I have Morphine, Bupivicaine and Baclofen in my pump and have it filled every 6 weeks.  I also have Oxycontin for breadthrough pain, which I thankfully don't have to take too often.

The Intrathecal Pump is a delivery system that cuts down or reduces the side effects that I had taking when I took opiates orally, plus I get significantly more pain relief.  I am surprised at how many doctors either don't know about the Pump, or believe it is only for terminal patients, which is how it was originally used.  

The Intrathecal Pump is also used for spasticity and can deliver Baclofen for those who need large doses.  

I realize the Pump is not the answer for everyone, there are some types of pain that might not respond to this delivery system and some people are not good subjects for it, but I can only speak for myself when I say I am very thankful that my doctor knew about the Pump and recommended that I have one.  

You can find out more about the Intrathecal Pump at www.medtronics.com  This is the company that manufactures the Pump I have and their website has information on pumps for spasticity and for pain.

   I realize there are many medications out there for pain control.  My professional, and personal experience shows that not all meds are equal.  I am an RN, worked in the Post Surgical area for 30 + years. Mostly in the Recovery Room and Critical Care ICU areas.

I have found that not everyone can tolerate certain medications (That goes with out saying of course) But I have also seen that not every medication is effective for everyone.

   I have given boat loads of Morphine to my patients and they had no relief, but giving them Vicodin had a good result.  While Fentanyl is great for very short term pain, but there are other meds that are much more effective for total pain control.

I had given a lot of Dilaudid Intravenously to my patients and this was the best drug and most predictable drug for pain I had used in my setting. But since I am now a Chronic (Actually a Constant) Pain Patient, I was happy to switch to Dilaudid for my hard to control pain. But I found that the PO, (By Mouth) dosage or route is not as effective as the IV.  Again I know that goes with out saying.

   I have been on the Oxycodones and the Hydrocodones and I am having such a hard time with my pain. I am also a Work Comp Patient and they are now denying all of my treatments. I have finally found a Physician that can do a very good epidural block, with excellent results.  But they are denying, thay are now also denying my medication, they say I do not need to be on the medications as they are not effective. So they are denying them all. (This is California and our Govenor the 'Governator' has told all work comp company's to deny all claims)  So I am in a spot that i do not know what to do.  I am in pain, and the Work Comp Company are reniging on my claim that they accepted many years ago.

With my low back pain oxycodone has been the best pain relief when coupled with naproxen. Even better than this is to strengthen your upper body, those with strong abs and back muscles suffer less. Pills are the alternative from a more liberal treatment such as surgery. People need to understand that drugs work best when combined with a physical regimen. Sure it hurts more for awhile while you start to strengthen, but I was abl to drop my daily OC intake from 90 mg down to aroumd 60 or 70 mg after just four weeks working at it. Good luck sufferer

My husband is preparing to have a pain pump inserted into his abdomen to control his back and leg pain.  What are the physical limitations that he will have to adhere to once he has undergone the trial and healed from the surgery??

I am allergic to most of nsaids, have severe gastric problems with any of the  nasids(sp?)Developed an ulcer from the best on of all, Advil. And now cannot take it either. So Tramadol has been prescribed and works quite well, and it takes about an hour to be effective, so someone on the Chronic Pain suggested I waken early ,put pill on nightstand and take an hour before arising. Then when I am up it is already working. Tried it and it works!!! So thank you to whoever mentioned it.

Susie

If tylenol was a majic bullet for back pain, the world woudl be a better place.  It may work for a mild sprain for a couple of days, but serious long-term back pain is NOT going to respond to a couple of tylenols and they are bad on the liver.  No medication is without a side effect.  You obviously have not had a serious back with degenerative disk disease, spondylosis, scoliosis, spinal stenosis and a failed back surgery.

I do foind that anti depressants, particularly Effexor is helpful and not an opiod.  So is Seroquel that allows me to sleep at night .  Lack of sleep definitely makes pain worse.

Dawn-Marie

i take, vicodin 7.5/500, klonpin 1mg, lyrica,prozac,restoril,zanaflex. here is how i beat the constipation.

i can not longer eat any processed foods at all.

i eat only fiber one cereal

i eat only anti inflammatory frutis and veggies

i do not eat any red meat

i do not eat any chicken

i eat limited amounts of fish but do take fish oil

i eat only fresh veggies, legumes and salads. i gave up junk food completey and fried foods because i had to.

this has helped me

i take many natural supplements ie, vit B's

fish oil, glousamine chrondrtion with msm.

this is what i must do in order to keep my system moving and it works, at least for me

For moderate to severe chronic pain, opiods are the best and safests treatments by far.  Although massive amounts of research to support this exist, doctors do not want to  prescribe them, no matter how much patients are suffering,  because they are afraid if the DEA.  They are afraid that if they write too many prescriptions for controlled substances, they will targeted by their local medical boards and investigated by the DEA, the federal Drug Enforcement Authority that derives its powers from the Controlled Substances Act.  Doctors are afraid of investigation,  State and/or Federal prosecution on false charges, loss of their medical licenses and even imprisonment.

As a result, chronic pain patients  who require opiod medication to function have become medical pariahs.  There are no advocates for us or protectors of us in  the med biz.  I stopped using the term health care a long time ago, because for most chronic pain patients it does not exist.  Our internists and family doctors lie to us and say that they can't prescribe narcotics.  We are shuffled off to either anesthesiologists, masquerading as pain managers, or addictionologists, also masquerading as pain managers.  If we refuse painful, dangerous, very expensive,  and at best, ocaccasionally only briefly effective, procedures from the anesthesiologists, we are labeled non-compliant and terminated as patients..  That label stays in our medical records and directly impacts or ability to get medical services from other doctors.  If  we are sent to an addictionologists, pretending to be a pain manager, and there is now a lot of money to be made in the fear mongering addiction biz, we are humiliated by being urine tested for drugs as though we are criminals.  We are also told that we are drug addicts and if we disagree, we are labeled as non-compliant drug addicts and are terminated as patients.  That label also stays in our medical records and almost always guarntees that no other doctor will ever prescribe another opiod med for us. Ever.

This country's War on Drugs which failed miserably at its designated mission of keeping illegal drugs out of the country,  has now turned into War on Pain Patients  who require opiate medication.  Therefore, it is now a political problem instead of a medical problem.  Political problems require political solutions.  Political solutions require money,  political power and  a large, well organized group of sophisticated activists.  I know of no group that meets those criteria at this time, but we must keep trying.  One phone call from one person, whose name we will probably never know, could put an immediate end to our suffering and our persecution by the DEA.

I will check out wht POPAN is doing.  I also suggest that you check out a site called Pain Relief Network and a site written by Dr. Alex Deluca, www.docalex.com or www.drdeluca.com, (I'm not exactly sure which, but you can easily find it).

MY DR CHANGED ME FROM 6 10.325 PERCOCET TO EMBEDA JUST APPROVED FDA  AUG 09 KINDA LIKE OXYCONTIN ITS TIME RELEASED AND 6 STRENGTHS I GOT 60MG 2X DAY PHARMACY HAD TO ORDER NOT IN STOCK  IN 06 HAD 4 EPIDORLS AND DISCOGRAM THEN FUSION 3 4 5 GOT  OSTEOMYLITIS IN SUMMER OF 07 FROM NEERVE BLOCK  WHICH I GET SEVERE PAIN IN R GROIN NEVER LETS UP   WILL B NEEDING MORE PROCEDURES ON L1 L2 SOON AS I HEAL FROM ALIF ANTERIOR  LUMBAR INTERBODY FUSION DR WENT IN GROIN AND TOOK OUT L5 S1 DISC  HAD CAGE AND FUSION ALSO 6 SCREWS AND 4 RODS FROM MY FUSION 3 4 5 ANYWAY  ANYONE OUT THERE TRY EMBEDA YET FDA APPROVED AUG 09 AND TIMED RELEASE