Lower back pain is very common. There are many different ways to
treat it -- part of which is due to the fact that none of them are the
perfect treatment for all patients.
When someone presents with back pain or neck pain, there are several
important issues that need to be considered. First, has there been any
trauma which would lead to a fracture. Second, is there any sign of
infection or cancer. Third, are there any symptoms such as bladder or
bowel problems or weakness or is there only pain. The possibility of
cancer, infection, or fracture can be set aside and ruled out with a set
of regular x-rays and a history and physical examination.
Assuming that pain is a major problem and that there is no evidence
of fracture, infection, or cancer, then the next issue is how to help
the patient. This is divided into three phases.
In the first phase, we have to relieve the pain. For mild pain, I
use Tylenol (acetaminophen). The Tylenol dose is one to two 325 mg
Tylenol every six hours or one extra strength (500 mg) Tylenol every six
hours such as a 12am, 6am, 12noon, 6 pm schedule. If necessary (if the
pain is not relieved by Tylenol alone), I add a non-steroidal
anti-inflammatory agent such as Naprosyn (naproxen) 250 to 500 mg every
12 hours. If needed, I will give naproxen in a dose of 250 mg every six
hours on a 3 a.m., 9 a.m., 3 p.m., 9 p.m. schedule if a 12 hour schedule
does not forstall the pain. In that manner, you can take something
every three hours for pain. It should be noted that all nonsteroidal
medications can hurt the kidneys, stomach and heart if taken in excess.
Also, despite recent bad press, they are probably safe taken as short
term (days) treatment. Naproxen appears safest of all the non-steroidals
for heart patients.
Learn more about neck and lower back pain
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