Common name: Backache; lumbar pain (Eng.); pananakit ng likod (Fil.)
Pain in the lower back is a very common problem experienced by almost 75 percent of the population at some point during their lifetime.
Range of pain depends upon the cause. It can occur gradually or suddenly. It is termed acute low back pain if it lasts for less than four weeks and subacute if the duration is four to 12 weeks. If the pain goes on for more than three months, it is considered as chronic.
Severe lower backpain is usually associated with a number of conditions including bulging disc/disc herniation, sciatica, spinal degeneration, spinal stenosis, osteoporosis, skeletal irregularities, fibromyalgia and spondylitis.
Commonly Prescribed Drugs
A. Non-Opioid Analgesics
- p-aminophenol derivatives are used to relieve fever and low-intensity pain. They do not have anti-inflammatory activity and do not affect platelet function. Side Effects: Mild side effects if taken within therapeutic doses such as nausea and skin rashes, and overdosage may lead to severe liver damage.
- NSAIDs or Nonsteroidal Anti-inflammatory Drugs Inhibit enzyme cyclooxyenase that helps in the production of prostaglandin, the mediator of pain, inflammation and fever. Side Effects: Gastrointestinal disturbances but can be minimized if they are taken with or after food or milk. Contraindication: In patients with asthma, peptic ulcer, bleeding disorder and impaired renal, hepatic or cardiac function.
- Salicylates Analgesics for low-intensity integumental pain, antipyretic, and anti-inflammatory. Caution: Aspirin and other salicylate-containing preparations should not be given to children with previous viral infection, e.g., influenza, cold, or chickenpox because of association to Reye's syndrome.
B. Opioid Analgesics
Also known as narcotics, are used for moderate-to-severe pain. Contraindication: Patients with respiratory depression and obstructive airways disease. Side Effects: Confusion, drowsiness, nausea, vomiting, and constipation may occur when these drugs are taken.
C. Skeletal muscle relaxants
They are also considered in the management of acute low back pain. Central-acting relaxants and benzodiazepines are used to relieve painful muscle spasms or spasticity in local trauma or musculoskeletal and joint disorders.