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The first step in successfully dealing with back or lower back pain is to correctly determine the cause of its occurrence. The reason for the provision of specialized assistance may be lumbodynia and backache against the background of hypothermia, lumbago, infringement of the sciatic or other peripheral nerves, herniated discs. To exclude other possible causes, it is better to be examined in full in the early stages after the onset of lumbar pain, including an examination by a neurologist, orthopedist, gynecologist or urologist, therapist and gastroenterologist.
Only having comprehensive information about the body of a patient with back pain, the attending physician will be able to correctly assess the situation and, accordingly, prescribe the correct complex treatment:
NSAIDs (non-steroidal anti-inflammatory drugs);
Glucocorticoid hormones;
Decongestants;
B vitamins;
Chondroprotectors of synthetic and homeopathic origin.
What are the drugs that relieve back pain in injections?
The approaches of modern physicians in relation to the treatment of back pain differ significantly from those concepts that were accepted before. This is due to differences in the arsenal of medications. The basic first-line drugs in the fight against back pain are NSAIDs, simple analgesics, paravertebral muscle blockade of pain points with local anesthetics against the background of fixation of the spine with a corset. As soon as pain and muscle spasm decrease, massage, manual therapy and exercise therapy are prescribed.
The second basic and quite effective remedy was the use of vitamin preparations. The best gradual analgesic effect was seen against the background of the injection of cyanocobalamin (vitamin B12). Other preparations of vitamins of this group (B1 and B6) have an additional neuroprotective effect in the fight against back pain. It has been established that only these vitamins are able to influence the metabolic processes and the structure of nerve fibers, synaptic mediators, normalizing the normal innervation relationships between muscles and an irritated nerve. These data have been confirmed by more than 90 large studies that have shown a high analgesic ability of B vitamins, both in isolated treatment and in enhancing the effect of NSAIDs.
Modern preparations of B vitamins are complex and contain all their representatives (B1, B6, B12) in combination with lidocaine. This enhances their analgesic effect, both general and local. It is best to prescribe them only for acute pain in the form of injections in combination with NSAIDs for a two-week course. After its completion, it is advisable to switch to taking tablet forms with a total duration of up to one month. Chronic back pain is less sensitive to therapy with combined vitamin preparations of group B.
Blockades and manual therapy
With the ineffectiveness of painkillers, there are indications for the use of injections of anesthetics around the spine (paravertebral blockades), elimination of deformities of the spinal segment and muscle tension through manual therapy and post-isometric relaxation. For blockades, solutions of local anesthetics are used, one of them in isolation, or a combination of two.
The injection technique consists in perpendicularly advancing the needle to its full depth through the skin at painful points around the spine. Usually, its end is in the muscles, where the anesthetic is injected. Immediately after this, manual therapy techniques are performed. The treatment session ends by applying a warm compress to the painful area. In no case should such procedures be carried out independently or by people without appropriate training. Only a qualified specialist can fully and correctly perform them.
Efficacy, contraindications and side effects of NSAIDs
NSAIDs and analgesics for back pain are symptomatic drugs. Only partially they provide pathogenetic treatment, affecting the mechanisms of pain, but not eliminating the underlying cause of its occurrence. A large number of side effects have been noted against the background of long-term use of fairly common drugs from the group of NSAIDs and analgesics (paracetamol, aspirin, dicloberl, etc.)
Conducted studies examining the comparative efficacy and side effects of all pain medications have established that there is no one remedy that would significantly reduce back pain more intensively than others. Even the most expensive of them turned out to be absolutely useless in some clinical situations. It all depends on the individual characteristics of the pathology and the susceptibility of the patient’s body to a particular NSAID. The only thing that is common to all of them is the side effects from the gastrointestinal tract.
According to the recommendations of the researchers, the least toxic manifestations were observed against the background of the use of drugs based on ibuprofen (ibuprom, nurofen). Even selective COX-2 inhibitors (Celebrex) did not appear to be as safe as ibuprofen. Therefore, when choosing an anesthetic drug, you need to be guided by common sense, scientific facts of real effectiveness and the frequency of possible side effects, as well as the price side of each remedy.
[Video] How to make an intramuscular injection: