8 best pills for back pain

*Overview of the best according to the editors of Healthy Food Near Me. About selection criteria. This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.

It would seem that back pain is such a familiar condition that there is no need to specify and understand what can be the source of the pain syndrome. As they say, you just need to take an ointment, put on a belt made of dog hair, or go to the bath, and everything will pass. But, alas, with back pain, the situation is far from being so simple. Even if we consider only the musculoskeletal system as the source of pain, then there are various methods of treatment, depending on the source of the pain syndrome. If you treat back pain correctly, then it will pass much faster than if you approach it thoughtlessly.

Here is a simple example. The patient has a herniated disc, which, protruding, regularly presses the nerve root. The spine reacts with swelling and inflammation. There are sharp backaches that are familiar to many people, especially the elderly. Some patients, having heard a lot of advice, do wrong, and at the very first lumbago they try to apply thermal procedures, or go to a hotly heated bath on the first day, and even more so, in the first hours of such acute back pain. Of course, the idea of ​​“steaming out the bones” is not bad, but not in the first two days after the onset of pain, when the swelling is still growing. Such thermal procedures are useful when the pain begins to subside a little.

Why is it absolutely not recommended to do this on the first day? Because the swelling of the nerve root has just arisen, and it continues to grow. And if you additionally give a heat load, then an additional blood flow (hyperemia) will be directed to the swollen root, and the edema will occur much faster, and the pain syndrome will intensify. There are many such cases when a morning backache in the morning after an evening bath gave an extremely strong increase in pain in the evening, and in the morning a person simply could not crawl out of bed, and was looking for a forced position to relieve pain. But on the third or fourth day, when the edema begins to subside, such a bath procedure is very useful, since the same hyperemia, but with a “reverse sign” will have a pronounced resolving effect.

It would be correct not to give heat from outside, but to apply a warming ointment using the human body’s own heat, or an ointment, cream, or gel with a cooling component, but it would be best to start treatment with back pain pills, or, in the best case , – with injections, or intramuscular injections.

Therefore, today there will be a story about the most effective pills for back pain. But before proceeding to the story, let’s figure out which structures of the musculoskeletal system can be sources of pain. Such knowledge will be useful, since it will immediately allow the use of certain drugs, depending on the nature of the pain symptoms.

What is the pain emanating from the musculoskeletal system?

According to statistics, most often a person is worried about pain in the lower back, and in neurology and therapy there is even such a syndrome, which is abbreviated as BNS, pain in the lower back. This is justified. Despite the fact that the most massive vertebrae and intervertebral discs are located at the bottom of the axial skeleton, the same department accounts for the greatest weight load of the entire body. In particular, it should be taken into account that many people of mature and elderly age are significantly overweight, which further increases the risk.

But we understand that in addition to the structures of the musculoskeletal system, pain from the abdominal cavity, pelvic organs and pancreas can radiate to the back, with an atypical form of a heart attack, and with the same atypical attack of angina pectoris. Therefore, if a patient takes pills, thinking that he has an exacerbation of osteochondrosis, but in fact he will have a heart attack, the result can be disastrous. Therefore, it is necessary to accurately characterize what the symptoms of back pain associated with the musculoskeletal system will be. As a rule, back pain exists in two standard “types”: neurogenic pain and muscle pain. What are the characteristic signs and symptoms of these two types of back pain, when will the pills help?

neurogenic pain

The source of neurogenic pain is sensitive portions of the spinal roots located on the sides of the spine, as well as individual branches of sensory nerves innervating large muscle masses.

A typical situation associated with neurogenic, or radicular pain, can be considered an attack of lumbago. Most often, the cause is a protrusion of the intervertebral disc or a hernia, which compresses the spinal root, and it swells in the narrow bony canals of the vertebra. This results in extreme, sharp, sudden pain that resembles an electric shock. A person instantly freezes in place, because any slightest movement, sneezing, coughing, laughing, straining, or turning the body causes a repeat of the pain attack. And thus, holding on to the lower back, you can stay in a forced position for a long time without the opportunity to lie down, sit down, or go out of great need. It is necessary to wait until the edema decreases a little, if nothing is treated.

At the same time, accompanying symptoms associated with damage to other structures of the root may also occur: transient weakness, for example, in the leg, numbness or crawling, too, or in the leg, or along the lateral surface of the thigh, or along the back of the leg from the buttock from below to the lower leg and even lower. All these are characteristic signs of neurogenic pain.

Muscle pain

Muscle pain is most often secondary. Above we have described the pain associated with the radicular or radicular syndrome. But we must not forget that the nerve root is surrounded by deep muscle masses, various fascia and ligaments. These soft structures also begin to respond to the swollen root with secondary pain impulses. Any muscle can react to nearby inflammation in only one way it knows: it contracts.

But the contracted muscle cannot fully eat, absorb oxygen and nutrients, and remove the resulting lactic acid. To do this, the muscle must relax. But if an inflammatory focus exists in the lower back for a long time, then the muscles also fall into chronic spasm. A vicious circle arises: excessive muscle spasm impairs blood circulation and increases the severity of pain, and pain, in turn, also provokes muscle spasm.

Muscle pain may be primary. The most common reason is a long forced stay in a monotonous position. Most often, office workers are familiar with such pain, most of whose day is spent working at a computer. These are characteristic persistent, low intensity, but constant and aching pains in the shoulders, in the interscapular region, in the lower back and in the neck.

A characteristic symptom of such myogenic pain is an irresistible desire to move. Movement, light gymnastics, massage of the back and shoulder girdle causes relief, blood supply to the muscles improves and pain syndrome decreases. If you feel the back of such a patient, then under the fingers you can easily find to the right and left of the spine, in the paravertebral region, as doctors say, muscle seals, or nodules. These are the signs of chronic muscle inflammation, when the muscles have been in a state of spasm for a long time.

Naturally, the correct treatment of such a myofascial, as doctors say, pain syndrome must necessarily include kinesiotherapy, that is, movement treatment. Injections, pills, various ointments, creams and gels, physiotherapy will bring only temporary relief, if you do not return muscle mobility, for which they are intended. When the patient begins to move, perform physiotherapy exercises, swim, then the muscular pain in the back will disappear by itself.

red flags

Before we start talking about drugs, about pills that are good for muscular and neurogenic back pain, let’s pay attention to the “red flags”. This is the name of special situations, or accompanying symptoms, which indicate that the condition can be much more serious, and everything is not so simple. It is possible that back pain in this case will be an echo of a more serious condition in which an urgent consultation with a doctor is needed, and self-medication with pills for back pain (as, indeed, with any other means) is strictly prohibited.

We list the most common symptoms and complaints that require urgent medical attention:

1. if acute pain in the lower back gives off shooting pains in the legs, is accompanied by numbness of the perineum, urination disorders, then we can talk about a serious condition – cauda equina syndrome, which may require urgent surgery, or at least hospitalization and consultation with a neurosurgeon ;

2. if back pain is accompanied by fever. Neurological pain associated with exacerbation of osteochondrosis will never be accompanied by fever;

3. the appearance of chest pain, the presence of shortness of breath. Currently, these signs, unfortunately, have become the most alarming. And not only in connection with the possibility of an angina attack and the development of myocardial infarction, but also as a sign of a coronavirus infection that has become severe;

4. the appearance of night pains, insomnia;

5. unexplained weight loss, anemia;

6. urinary incontinence associated with pain, or, conversely, urinary retention;

7. progressive gait disorder;

8. the presence of a noticeable asymmetry of the muscles on the legs, when one of the limbs looks thinner than the other, and measuring with a centimeter tape confirms these fears.

In this case, we are talking about muscle hypotrophy associated with impaired peripheral innervation, that is, with partial paralysis, that is, paresis. A typical case is when a patient has compression radiculopathy in the lumbosacral spine, for example, at the level of L5-S1. Then, with progression, there is weakness in the foot, the inability to stand on toes and heels, the foot begins to twist, and if you do not consult a doctor, then all this can lead to disability.

the appearance of acute back pain in the elderly, and especially in the established diagnosis of osteoporosis. It could be a compression fracture of the vertebrae.

Of course, some other data should also be taken into account: for example, a long history of tuberculosis, with the possibility of tuberculous spondylitis, the presence of chronic foci of infection, which can lead to the development of acute osteomyelitis. Therefore, in any case, with the above symptoms and signs, it is necessary to consult a specialist. Finally, we turn to the treatment of acute and chronic back pain with the help of pills.

Pharmacotherapy for back pain

The usual therapeutic tactic is to eliminate back pain as quickly as possible with a short course of intramuscular injections. And then pills are prescribed for back pain. This is the usual standard of emergency care. The advantage of the injectable form is that the drug enters the bloodstream directly, and does not pass through the liver, the microsomal system of which can reduce the concentration of the drug and slow down the effect.

Therefore, most drug manufacturers produce two forms at once: in ampoules and tablets. The standard course is 2-3 days in the form of intramuscular injections, and then switching to tablets using local remedies: ointments, creams, gels, home physiotherapy products. But some physiotherapeutic agents can be used immediately, from the first day. These are the Kuznetsov or Lyapko applicator, home electrotreatment products, and other methods, except for thermal ones. However, in the event that the pain is not extremely strong, then tablets can be used immediately. What drugs, and what groups will be useful? Let’s figure it out.

In neurology, for the treatment of acute back pain, the “palm tree” belongs to non-steroidal anti-inflammatory drugs, or NSAIDs. Muscle relaxants of central action are also used to relieve pain syndrome emanating from muscle tissue. It is the drugs of these two groups that will be in today’s review.

What other means are used? This:

1. corticosteroid hormones, which are the most powerful anti-inflammatory drugs, but they are not prescribed in tablets. Hormones are sometimes part of therapeutic blockades, with the help of which deep muscle masses are cut off, or drugs are administered directly paravertebral, that is, next to the inflamed roots;

2. therapeutic blockades also include local anesthetics, such as lidocaine;

Neurotropic vitamins of group “B”: thiamine, pyridoxine and cyanocobalamin, or B1, B6 and B12.

Vitamins do not have an analgesic effect, and are used in complex therapy as a means of improving nervous trophism. Therefore, if someone advises you that in order to relieve acute back pain, you need to start with intramuscular injections of vitamins, then he will be wrong. Vitamins work slowly, and they are not suitable for emergency care.

What else will not help to relieve acute or chronic back pain? Naturally, these are chondroprotectors. This is a huge number of drugs that actually belong to nutritional supplements. They are sometimes advised to relieve pain, but these are myths and fairy tales. Here is a small example and a little investigation.

The myth of chondroprotectors

There is a well-known dietary supplement Teraflex, which consists of chondroitin sulfate and glucosamine. This is a typical “chondroprotector”. It has long been proven that chondroprotectors do not affect the end points, the structure of the articular surfaces, and, in fact, are produced according to the great desire of the mass of consumers: they are medicines.

Despite this, Teraflex has a rather high cost. One package of 60 capsules will cost from 1400 to 1500 rubles. The therapeutic benefits of Teraflex are exactly the same as those of jelly or natural jelly, but the big money that the grandmother will pay will complement the placebo effect, which will unconsciously allow her to believe that she is feeling better.

But! It is worth adding the non-steroidal anti-inflammatory drug ibuprofen to the same Teraflex on the sly, and it will really begin to help and remove low-intensity back pain, but only due to an additional component – ibuprofen, which the manufacturer cunningly and prudently introduced: they introduced ibuprofen, and laurels will go to Teraflex as a trademark. The cost of this Teraflex Advance will already be higher: from 1400 to 1700 rubles.

Now let’s see how much ibuprofen is in one Teraflex Advance capsule. Referring to the official instructions, you can see that each capsule contains 100 mg of ibuprofen. This is what big money is paid for. And how much can you buy just ibuprofen in the same dosage? For example, the drug Next Uno Express, in the amount of 20 capsules, each containing 200 mg of ibuprofen, can be purchased, on average, for 250 rubles. If we add to this a package of another 10 capsules, in the same dosage, then we will get an amount of ibuprofen similar to that in one package of Teraflex Advance.

As a result, having spent 400 rubles on two packages of good ibuprofen, we will get the same therapeutic effect as from one package of Teraflex Advance, paying four times (!) Less.

Rating of the best pills for back pain

Before you start listing the most interesting and high-quality drugs for back pain, you need to recall that first an international non-proprietary name is given, that is, INN. After that, the names of the trade names of the drug come in brackets, and the first, as a rule, is the original remedy that was first created, and to which all other commercial copies, or generics, are equal. This medicine is called the original drug. The original drug always costs a little more than the rest, but it is the leader, it is always of higher quality. For the original remedy, there is the largest number of studies, both in terms of effectiveness and safety. Sometimes the creation of a drug takes many years and many hundreds of millions, and sometimes billions of dollars. Therefore, it must be remembered that the price of the original drug is always justified.

On the other hand, one should warn and warn against buying the cheapest, as a rule, domestic generics. It is impossible to save on health, since the extreme degree of cheapness does not say anything about quality. The following is a breakdown of prices relevant for May 2020 for pharmacies of all forms of ownership in the Russian Federation. The drugs included in the list are all present in the National and international recommendations, in the algorithms and protocols for managing patients with acute and chronic back pain. There is no promotional purpose of listing or delisting any drug, and the material provided below is for informational purposes only.

NSAIDs: leaders in the treatment of back pain

In our list of 8 tablets for the treatment of back pain, 7 are NSAIDs, and this is justified. These are the means, the ancestor of which can be considered the bark of the white willow, and then – acetylsalicylic acid. All of these remedies lower fever, fight inflammation and relieve pain. We will be interested in the last two categories, and we will exclude antipyretics from the list.

Paracetamol and acetylsalicylic acid can be considered a typical representative of antipyretics. The strongest pain reliever that comes first is ketorolac. The most powerful anti-inflammatory drug is diclofenac, and we will present it in the best possible way: the highly effective Voltaren. All drugs from this group can be either selective or non-selective cyclooxygenase inhibitors.

Selective ones are safer and cause fewer complications, of which the most important can be considered an exacerbation of gastric ulcer, duodenal ulcer, the occurrence of erosive and ulcerative gastritis and effects on the liver. And non-selective drugs are more rough. Perhaps the most crude of all NSAIDs, which therefore requires a minimal course of therapy, is diclofenac. But unfortunately, it is also the most effective. Selective cyclooxygenase type 2 inhibitors are meloxicam, nimesulide, ketoprofen and dexketoprofen, as well as celecoxib. They are increasingly safe, but none of them show such high activity as diclofenac, and they act softer, but this avoids complications and side effects.

Ketorolac (Ketanov, Dolac, Ketocam, Ketorol, Ketofril)

Rating: 4.9

Ketanov, like other types of ketorolac, are very strong painkillers. Their analgesic effect is stronger than that of other NSAIDs, and comes close to narcotic analgesics. Ketans can be used as intramuscular injections after surgery for pain relief, and it can completely relieve even toothache for a while, this is a very valuable quality. The range of application of Ketanov is joint pain, back pain, muscle pain, radiculopathy, neuritis.

It is necessary to take the medicine in short courses. A single dose is 10 mg, or one tablet. In any case, the maximum daily dose should not exceed 40 mg, and the duration of the course should not be longer than five days. Ketanov is produced by the Indian company SUN, and one pack of 20 tablets, just 10 mg each, will not cost more than 60 rubles. The only “organizational” drawback: Ketanov and its analogues have become prescription drugs for some time now, and just like that, without a prescription, it is unlikely that they will sell it to you in a pharmacy.

Advantages and disadvantages

The big plus of Ketanov is that it is the most powerful pain reliever of all NSAIDs, it is a cheap remedy, and is available in all pharmacies. A fly in the ointment is the need for a recipe, but there is one more minus that you should definitely remember. This disadvantage is a continuation of the advantages. The strength of the analgesic effect is so high that if you made a mistake and mistaken for back pain any acute process in the abdominal cavity, pancreatitis or heart attack, the pain will subside, but the disease will remain.

Therefore, it is necessary to use it only when there is complete confidence that the source of pain is the musculoskeletal system, and not acute surgical pathology. In addition, you need to remember about contraindications. This is an erosive and ulcerative lesion of the gastrointestinal tract, pregnancy, childhood, and an attempt to treat chronic pain with Ketanov. It is not intended for this, it is an ambulance.

Meloxicam (Movalis, Amelotex, Artrozan, Genitron, Mirlox)

Rating: 4.8

Movalis is the original meloxicam, the first noble representative of its group, it is produced in Germany by the pharmaceutical company Boehringer Ingelheim. It can be purchased in ampoules for the acute treatment of acute back pain, and in tablets, 15 mg and 7,5 mg. This drug is not cheap: for a package of 10 tablets of 15 mg, you will have to pay from 400 to 550 rubles. The price is due to the fact that this is the original meloxicam, the first and the best, as well as the fact that this agent already belongs to the selective COX-2 inhibitors, and is safer than non-selective agents. Movalis has a balance between analgesic and anti-inflammatory effects, and the anti-inflammatory effect is more pronounced. It is prescribed for acute back pain, both in ampoules and in tablets.

The pain should be associated with the musculoskeletal system: these are sciatica, arthritis and arthrosis, radicular symptoms, diseases of large joints. It is also used in rheumatology. It is necessary to take Movalis by mouth, one tablet once a day. As soon as the therapeutic effect is achieved, it will be necessary to reduce the dose and switch to 7,5 mg tablets. It is advisable to “cover” the stomach during treatment with omeprazole, or other proton pump blockers, at least at a dose of 20 mg daily. Reception of Movalis, preferably, should not be longer than 3-5 days, otherwise, you should consult a doctor.

Advantages and disadvantages

Movalis is a balanced drug that has a pronounced analgesic effect and facilitates movement. But it must be borne in mind that if you have a peptic ulcer of the stomach or duodenum, if there is an inflammatory bowel disease, for example, Crohn’s disease, then the drug is prohibited for use, especially if there is an exacerbation of the ulcer. Contraindications will be pregnancy and lactation, a disease of the blood coagulation system, and especially in the direction of hypocoagulation, that is, hemorrhagic syndrome. Like all NSAIDs, the drug is prohibited for use in people with bronchial asthma, which is combined with nasal polyposis, or aspirin intolerance.

There are also side effects, among which the most common are headache, dyspepsia and abdominal pain, nausea, and other symptoms. But if back pain needs to be stopped quickly, for example, in order to get to the hospital, then the Movalis tablet will help you with this, but an intramuscular injection will help you even better.

Diclofenac (Voltaren, Diklak, Diclobene, Diclogen, Dicloran, Diclofen, Ortofen)

Rating: 4.7

Perhaps, Voltaren, or rather, diclofenac, can be given first place: both in terms of the strength of the action, as well as in the severity of side effects, and in the presence of contraindications. Diclofenac is the strongest in terms of anti-inflammatory effect (and ketorolac in terms of painkillers), but at the same time the most dangerous of all NSAIDs if used unreasonably.

Diclofenac, manufactured by Novartis, is called Voltaren. And 20 enteric tablets of 50 mg each will cost from 250 to 300 rubles, this is a relatively inexpensive price. But on the other hand, you will get the best of all diclofenacs, the most pronounced effect, and therefore, you may need a minimum dosage and a minimum course of administration, and this is very important. If it seems to you that Voltaren is quite expensive, then you can purchase domestic Ortofen, 10 tablets at a dose of 25 mg will cost from 41 rubles. Diclofenac should be prescribed in cases where there is a really pronounced pain syndrome. If your back hurts “a little”, then you can always use, for example, Nimesil, which will be discussed below.

The dose that starts to work is 100 mg once a day. If it hurts a lot at night, then you can increase the dose to 150 mg, but this is the maximum total daily dose. It is advisable to “cover” the gastric mucosa with omeprazole at a dose of 20 mg while taking diclofenac. It is desirable that the course of taking diclofenac does not exceed 2-3 days, and does not exceed 5 days at most without consulting a doctor.

Advantages and disadvantages

The advantage of this drug will be a pronounced force of impact, a really significant relief of pain, including severe pain. But it must be borne in mind that there are much more contraindications to taking this remedy than other drugs from the NSAID group. These include chronic obstructive pulmonary disease, chronic infectious respiratory diseases, diabetes mellitus, severe arterial hypertension, peripheral vascular disease, old age, people who are malnourished or underweight. Voltaren is contraindicated in people who take anticoagulants and antiplatelet agents, antidepressants from the SSRI group, as well as people who smoke and drink alcohol.

When using diclofenac, you should remember that this is a “time bomb”, and you need to get rid of it as soon as you get the desired effect. There are many facts: people started using diclofenac daily because it helped so much. After a few years of such “planting” on Diclofenac, people ended their life with toxic drug-induced hepatitis, massive hemorrhagic stroke, and other unpleasant “surprises”.

Nimesulide (Nimesil, Friend, Nemulex)

Rating: 4.7

Nimesil is the only drug that is not presented in pills for back pain, but in powder for back pain. But that doesn’t make it any worse. Nimesulide is also a representative of selective NSAIDs, which acts quite gently, it has few side effects. It reduces muscle and joint pain, eliminates back pain, helps with sciatica, sciatica, that is, inflammatory lesions of the sciatic nerve. Nimesil is also used for muscle strains, and even for painful periods.

The standard dosage is one powder (100 mg) diluted in a glass of warm water twice a day. But, as practice has shown, 1 powder is quite enough to stop pain of not very high intensity. It should be remembered that the maximum duration of the course of treatment should not be longer than 2 weeks. But for Nimesil, as well as for any remedy from the NSAID group, the rule must always apply: the minimum effective dose should always be used, and the course should be as short as possible.

Advantages and disadvantages

The advantages of Nimesil include mild action. But you need to take into account contraindications. This is a standard combination of bronchial asthma with nasal polyposis, aspirin intolerance, inflammatory diseases of the gastrointestinal tract, exacerbation of an ulcer, or erosive gastritis, a violation of the blood coagulation system. Do not use Nimesil and its analogues in case of severe liver and kidney failure, in case of pregnancy and breastfeeding, up to 12 years of age, as well as to persons suffering from alcoholism. Nimesil should be used with caution while taking Warfarin, antiplatelet agents, and glucocorticosteroid drugs. Of the side effects, nausea is often noted, stool thinning, this is the most common side effect. However, if you have low-intensity back pain, for example, associated with a bruise, a fall from a bicycle, a subcutaneous or intermuscular hematoma, and you walk and groan, then taking 2-3 bags of Nimesil according to the scheme will completely eliminate the pain syndrome, increase range of motion in the back and improve the quality of life.

Ketoprofen (Ketonal, Ketoprovel, Flamax)

Rating: 4.7

Ketonal is ketoprofen, which is produced in Europe. The owner of the registration certificate is Lek from Slovenia. Ketonal is available in tablets, 100 mg, 20 pieces per pack. The cost of such a package, on average, is 180 rubles. Ketoprofen in its effect resembles both Movalis and Nimesil. It is also remarkably suitable for the treatment of various pathologies of the musculoskeletal system, both inflammatory and non-inflammatory etiology. After all, back pain can be without inflammation, for example, due to elementary sprains, muscles, falls or bruises. But Ketonal can be prescribed for rheumatoid arthritis, and for headaches, migraines, and sciatica.

The medicine should be swallowed whole and washed down with a liquid of at least half a glass. The maximum dose is two tablets per day, i.e. 200 mg. In addition to tablets, the drug is available in capsules, in tablets of prolonged action, acting for a long time. They are taken one tablet once a day and can therefore be taken at night. Ketonal is also available in the form of rectal suppositories, and in the form of ampoules for intramuscular injections.

Advantages and disadvantages

Ketonal has typical side effects characteristic of NSAIDs, selective COX-2 inhibitors. Ketonal is contraindicated in the same situations: hypersensitivity to salicylates, bronchial asthma plus nasal polyposis, exacerbation of stomach ulcers, blood clotting disorders, pregnancy and lactation, and other conditions. Of the side effects, again, most often there are disorders of the gastrointestinal tract: nausea, dyspepsia syndrome, abdominal pain. But the side effects are dose-dependent, and after 2-3 days, when the pain subsides and the dosage decreases, the severity of the side effect also decreases, or it disappears completely. Ketonal is a highly effective drug that can only be found in every home medicine cabinet. It should be remembered that there is also Ketonal-cream, so the patient who is helped by ketoprofen can stock up on his favorite drug in a variety of forms.

Dexketoprofen (Dexalgin 25, Dexonal)

Rating: 4.6

If there is ketoprofen, which helps well, then why do we need dexketoprofen as well? What is its advantage? Dexalgin-25 is a drug that acts extremely quickly. It is indispensable in the case when it is necessary to relieve pain as soon as possible, for example, after an injury or muscle strain, you need to go home. In addition to anti-inflammatory and analgesic effects, Dexalgin-25 can also be used as an antipyretic.

From the moment of admission, only 30 minutes pass, and the effect is already deployed. But at the same time, the effect of dexketoprofen is quite short, and ranges from 4 to 6 hours. A typical condition for which it should be taken is lower back pain after an injury, a fall, or due to sciatica, which prevents sleep in the evening. After half an hour, the patient will almost no longer feel pain, will fall asleep, and after 6 hours the medicine will already be removed from the body. In addition to the pathology of the musculoskeletal system, Dexalgin can be used for the relief of a rapidly occurring toothache, with painful periods, and in other cases.

It should be used in half a tablet, or 12,5 mg. This is the average recommended single dose. If it is necessary that the pain relief and anti-inflammatory effect last all day, then you can take one tablet of 25 mg from 1 to 3 times a day, every 8 hours. The maximum daily dose should not exceed 3 tablets, or 75 mg. This drug is produced by the German company Berlin-Chemie, and one pack of 10 tablets of 25 mg will cost from 280 to 330 rubles.

Advantages and disadvantages

Despite the speed of action, the drug is still a non-steroidal drug, contraindications to its use are a standard set, from stomach ulcers to increased bleeding, Crohn’s disease, and pregnancy with a period of breastfeeding. All contraindications are carefully spelled out in official instructions, and every sane person, before starting treatment, will carefully get acquainted with it. In general, you need to make it a rule to read the official instructions even if the drug is prescribed by a doctor. The drug can cause dizziness and mild drowsiness as side effects, so you need to check its effect for several hours before driving. But with all the shortcomings, the drug can be in the first aid kit of every active person, since it anesthetizes very quickly, and it will be especially relevant in winter, when there is an increased risk of injury on the street.

Celecoxib (Celebrex, Dilaxa)

Rating: 4.5

Celebrex, which is produced by the American company Pfizer, is the ancestor of the coxibs group, but coxibs are also type 2 cyclooxygenase inhibitors, and just relatively new non-steroidal anti-inflammatory drugs. However, they are quite expensive. A package of 10 capsules of Celebrex 200 mg each will cost from 430 to 550 rubles. Thus, Movalis and Celebrex will be the leaders in price for back pain pills. Celebrex is indicated for arthritis and arthrosis, joint pain, ankylosing spondylitis and lower back pain syndrome, muscle pain, and painful periods.

The medicine must be taken orally, without chewing, and try to follow the principle: the minimum dose and the shortest course. So, symptomatic treatment of pain in the lower back is 100 mg twice a day. Usually two or three days are enough for the condition to improve significantly with the uncomplicated course of the pain syndrome, together with the use of local preparations, ointments, gels and creams, physiotherapy.

Advantages and disadvantages

Celebrex is a member of a new class of coxibs, which means that there is not enough clinical experience yet, although the drug has been used for more than 20 years. Celebrex can also have an antipyretic effect, but the coxibs group has some adverse effects on the cardiovascular system, since it can provoke the development of thrombosis. The thrombotic risk increases in proportion to the dosage, and Celebrex can also lead to an increase in blood pressure. Therefore, if the patient has a diagnosis of hypertension, then the medicine should be used with caution. Also, the drug can affect the exacerbation of gastrointestinal ulcers, and cause bleeding when used together with Warfarin. But still, the drug is good, modern, and is safer than the same diclofenac. If we are talking about the relief of pain in the back of low intensity, then Celebrex tablets, taken in a short course by a middle-aged person, will be safe and effective.

Tolperisone (Midocalm)

Rating: 4.5

Finally, to conclude this brief review of popular back pain pills, consider Mydocalm, or tolperisone. This is a drug from a completely different group. It does not belong to NSAIDs, and does not affect inflammation in any way. Its task is to eliminate the secondary, muscular component of pain by changing muscle tone. We said above that a muscle in a state of chronic spasm is a source of painful pulsation, and it is not able to get out of this spasm on its own: pain generates spasm, and spasm generates pain. Mydocalm affects the central nervous system, on special neurons that are located in the lateral horns of the spinal cord and affect muscle tone. Passing or not passing impulses from neurons, it causes the muscles to relax. It is used in all painful conditions, with aching pains, with tightness of the muscles in the back, as well as in patients with paralysis, in order to reduce the severity of spasticity. Mydocalm is produced by the well-known Hungarian company Gedeon Richter, and a package of 30 tablets of 150 mg each will cost from 330 to 400 rubles. Adults should take it starting at a dose of 50 mg 2-3 times a day, and the average effective dose is 150 mg 2-3 times a day.

Advantages and disadvantages

The drug is well tolerated, does not cause drowsiness. Side effects may include lowering blood pressure, abdominal discomfort, and mild muscle weakness. Mydocalm is indispensable in complex therapy together with drugs of the NSAID group, massage after the relief of acute pain, the use of physiotherapy and the application of local preparations to the skin of the back: ointments, creams and gels. Mydocalm can also be used in a short and long course, it does not cause such serious side effects as NSAIDs. Therefore, Mydocalm can be used for 2-3 weeks as directed by a doctor. Only one thing can be said: if you use Mydocalm together with the above tablets for the treatment of back pain, then the result will come faster, and Mydocalm will make the courses of NSAIDs shorter and the doses minimal.

Attention! This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.