Posted on 06/28/2022 8:31:02 PM PDT by ConservativeMind
Spine-related pain is increasingly common in older adults. While medications play an important role in pain management, their use has limitations in geriatric patients.
Now a new review study has found acetaminophen is safe in older adults, but ibuprofen may be more effective for spine-related pain. Non-steroidal anti-inflammatories should be used short-term in lower dose courses with gastrointestinal precaution while corticosteroids show the least evidence for treating non-specific back pain.
Additionally, nerve pain medications (gabapentin and pregabalin) can be used in older persons, with caution to dose and kidney function.
Among their findings:
Pain medicines gabapentin and pregabalin may cause dizziness or difficulty walking, but may have some benefit for neck and back nerve pain (such as sciatica) in older adults. They should be used in lower doses with smaller dose adjustments.
Some muscle relaxants (carisoprodol, chlorzoxazone, cyclobenzaprine, metaxalone, methocarbamol, and orphenadrine) are avoided in older adults due to risk for sedation and falls. Others may be helpful for neck and back pain, with the most evidence for tizanidine and baclofen. These should be used in reduced doses, avoiding tizanidine with liver disease and reducing baclofen dosing with kidney disease.
Older antidepressants are typically avoided in older adults due to their side effects, but nortriptyline and desipramine may be better tolerated for neck and back nerve pain at lower doses. Overall, newer antidepressants (namely duloxetine) have a better safety profile and good efficacy for spine-related nerve pain.
Tramadol may be tolerated in older adults, but has risk for sedation, upset stomach, and constipation. It may be used in lower doses after alternative medications have failed and works well with co-administered acetaminophen. Opioids are avoided due to their side effects and mortality risk, but low dose opioid therapy may be helpful for severe refractory pain with close monitoring of patients clinically.
(Excerpt) Read more at medicalxpress.com ...
“may”
The use of the word says more studies are needed.
Pain is a very common symptom.
By 2022 we should know how best to treat it.
I’ve had chronic spinal issues since my 30s, due to congenital issues aggravated by two accidents.
Beer. And Aspirin. (Not necessarily together.)
“Beer. And Aspirin”
My college roommate at Stanford is now an ex-retired NFL’er. He “upgraded” his doctor’s medication for pain involves Jack Daniels.
supposedly- Acetaminophen and Motrin together work as well as opioids- (But i did NOT find that to be the case myself), though it did work better than one or the other alone-
Gababentin and lyrica etc can cause suicidal thoughts so be aware of that if folks are seeking those meds-
I think one factor that has to be taken into account is developing tolerance to the opioids. I agree (from my own experience) that an NSAID + acetaminophen combination works better than either alone but pale compared to the first dose of an opioid. So on the first dose the opioid is much superior. But tolerance develops so quickly to the opioid that the OTC combination is better after a few or a dozen doses, unless the opioid dose is rapidly increased, which we all know you don’t want to do.
It would be great if it wasn’t for the increased different medical problems that older people have. Many times a new one being brought on by a previous one. Drug interactions are abundant and the availability of some of the drugs are either too expensive or illegal. Wish there was a one size fits all set of medications that would help but there are too many variables.
wy69
Bookmark.
EC-Naprosyn 375 mg tablet, delayed release. Works wonders for me, and doesn’t bother my stomach at all, like regular Naprosyn. Fortunately I don’t have to take it every day.
For whatever reason, you can’t buy enteric coated Naprosyn over-the-counter, have to have a prescription. I’ve run into Dr’s who don’t know it exists, and pharmacies that don’t regularly carry it.
I’m dealing with a household member with a slipped disc. That is very painful and and have found nothing to relieve the pain yet. Physical therapy is helping but that takes time. Nerve pain is different from muscle pain where muscles have tensed and tightened. And some nerve pain treatments have really bad side effects.
I had a pinched nerve twice in 2019 and found out that nothing really helped, ibuprofen and aspirin and Lidocaine did not work. I bought a easy@home Tens Plus Massager similar to this: https://www.amazon.com/Easy-Home-Professional-Electronic-EHE012PRO/dp/B01MXSPBUW
It dulled the pain.
The pinched nerve went away when I did stretches, pushups, lift weights.
The pain was from my neck thru the left arm to the my thumb and forefinger
I was in the grocery parking lot. I had forgotten to unlock the passenger door. I keep my store bags on the passenger seat & floor. I had to go in the drivers side and unlock the door by hand, then go back to put the bags on that seat.
A man who was parked was watching me and wondered if I was alright. I explained that I have sciatica. He said he used to have it, but someone told him to get Dr. Scholls arch supports and wear them. Said it cured his pain. Also said another man he knew tried them and all pain was gone in 3 weeks.
Next outing, I’ll buy them and I hope and pray that they actually work. What a blessing that would be! He also told me that arch supports can be custom made, but they cost $200.
I recently, after some research into back pain, went to sketchers.com and ordered a pair of their arch fit tennis shoes..
Man, what a difference they make!!!
They are pricey, but very effective
I recently, after some research into back pain, went to sketchers.com and ordered a pair of their arch fit tennis shoes..
Man, what a difference they make!!!
They are pricey, but very effective
ping
Wonderful!
My research said that you need shoes with arch support, walking shoes, and a firm sole
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.