Painkillers for back pain: Benefits, side effects and alternatives

When acute pain occurs in the musculoskeletal system, many people's first impulse is to take painkillers. They offer quick pain relief and short-term improvement in mobility. However, there is a problem: Painkillers only treat the symptoms and not the cause, which is why they are generally not suitable as a stand-alone treatment method. What's more, if used incorrectly, painkillers can cause physical damage such as allergic reactions, stomach ulcers and kidney, liver or cardiovascular problems.

Over-the-counter medications such as paracetamol, ibuprofen and diclofenac are particularly popular for back pain - which, according a report published by the Swiss medical journal "Schweizer Ärztezeitung" - affects up to 67% of the Swiss population several times a year. Opioids may be prescribed for severe pain.

The use of painkillers as a short-term treatment definitely has its legitimacy, which we do not want to question. However, it is essential to adhere to the recommended dosage and not to exceed the intake time. You also need to be aware that taking painkillers is only a temporary solution and not a permanent cure.

This is where exercise comes into play. Targeted, health-promoting exercise is the most effective, sustainable treatment for many causes of pain. Physiotherapy is highly recommended, especially for sub-acute chronic back pain.

Disclaimer: This is not medical advice. Consult your doctor to determine the appropriate treatment for your individual needs.

What are the most common painkillers and how do they work?

There are different types of painkillers that work in different ways. Below we have divided them into prescription and over-the-counter and briefly summarized them.

Over-the-counter painkillers

The most commonly used over-the-counter painkillers are non-steroidal anti-inflammatory drugs (NSAIDs). They are used for a variety of pains - from back pain to menstrual pain and headaches. NSAIDs also score points for their fever-reducing and anti-inflammatory effects. Not all NSAIDs are available over the counter, and some are only available in a reduced dose. You can obtain the following active ingredients from pharmacies without a prescription:

• Ibuprofen
• Diclofenac
• Naproxen
• Acetylsalicylic acid 
• Paracetamol (also has a pain-relieving and fever-reducing effect, but unlike the other NSAIDs it does not have an anti-inflammatory effect).

Caution: Just because these medications can be purchased without a doctor's prescription does not mean that they cannot cause side effects. Adhere to the recommended dosage and do not exceed the recommended intake time to minimize side effects.

Prescription painkillers

For very severe pain, your doctor may prescribe an opioid painkiller. Opioids act primarily in the central nervous system, i.e. in certain cells of the brain and spinal cord. The active substance suppresses pain signals there. In addition, mental activity is suppressed and feelings of anxiety are reduced. They can have both euphoric and dysphoric effects on the patient's mood. Opioid painkillers include, among others:

• Morphine
• Fentanyl
• Tramadol
• Oxycodone
• Codeine
• Tilidine

Possible side effects

Non-prescription painkillers

• Painkillers containing the active ingredient acetylsalicylic acid can cause an increased tendency to bleed, as they have an effect on blood clotting.
• Preparations containing the ingredients ibuprofen, naproxen and diclofenac can lead to ulcer formation, bleeding and inflammation in the gastrointestinal tract if the dosage is too high or if taken over a long period of time. These can manifest themselves as heartburn, flatulence, abdominal pain and nausea. Vomiting or diarrhea are also possible side effects.
• Painkillers based on paracetamol can lead to an increase in liver values and cause blood count changes. Liver damage can also occur in the event of an overdose.

Prescription painkillers

• There is a high risk of dependence on prescription painkillers if they are taken for longer than prescribed.
• A common side effect of opioids such as morphine, fentanyl, tramadol, oxycodone, codeine and tilidine is constipation.
• Some opioids cause dry mouth, reduced sexual desire and itching.
• Stopping opioids can lead to withdrawal symptoms such as nausea or vomiting, sweating or dizziness, tiredness, headaches or difficulty concentrating.

What should you watch out for when taking painkillers?

If you want to take painkillers, there are some important things you should bear in mind. Here are some tips for taking them safely and effectively:

• Read the package insert:
  Read the label and package insert carefully before taking the medication. Pay attention to the recommended dosage, possible side effects and potential interactions with other medications.
• Interactions with other medications:
  This recommendation follows on from the previous point. Painkillers can interact with other substances (such as alcohol). Therefore, it is important to discuss all medications you take with your doctor, including over-the-counter medications and supplements.
• Do not take on an empty stomach:
  Some pain medications can cause stomach problems, especially if taken on an empty stomach. Therefore, painkillers should be taken with enough liquid and preferably after a small meal.
• Medical consultation:
  If you are taking other medication or have a pre-existing medical condition, you should consult your doctor before taking painkillers.

Alternative treatment methods

Painkillers are often the first choice when it comes to relieving discomfort. However, there are numerous alternative approaches that are not only effective but can also be gentler on the body. Here is an overview of various treatment methods that you can consider for back pain.

1. Exercise therapy

Targeted exercise therapy, especially in the form of physiotherapy, is an effective way of treating acute and chronic pain in the musculoskeletal system. A comparison with painkillers shows that, in the example of back pain, physiotherapy addresses the underlying cause of the pain and does not just temporarily mask the symptoms. In addition, exercise therapy can reduce muscle tension and relieve posture. Regular exercise also prevents the development of further pain.

Another plus: In contrast to painkillers, physiotherapy has no risk of dependency and no side effects.

2. Massages, heat patches and creams

Massages can help relax the muscles. Tension can be relieved and blood circulation improved through targeted massaging. This can have a positive effect on physical well-being.

Heat patches, creams or pain gels can also provide quick relief for localized pain, especially tension. The heat promotes blood circulation and relaxes the muscles.

However, these measures only provide temporary relief. They do not provide long-term relief.

3. Herbal remedies

Devil's claw, a natural medicinal plant, is often used to support joint and back pain due to its anti-inflammatory properties. Its effectiveness has been proven in a study that describes it as an attractive alternative to NSAIDs.

Overall, these alternative approaches illustrate that pain relief does not necessarily have to involve or be limited to the use of medication. The decision to use a particular method depends on individual factors and it can be useful to combine different approaches. A consultation with a healthcare provider can help to find the optimal strategy for pain management.

Pain-free through exercise therapy with Akina

If certain movements increase pain, many sufferers try to limit or avoid this type of movement. However, long-term immobilization has a negative effect on pain, as the unused muscles are broken down and the tendons and joint capsules contract. As a result, movements can only be performed with greater pain or not at all. It also leads to incorrect posture and tension, which also increases the pain. Regular training can counteract this.

However, it is not only strengthening the muscles that has a positive effect on the perception of pain. Targeted exercise releases happiness hormones, which - like opioids - have a pain-relieving effect. It is therefore important to motivate yourself to exercise regularly and over the long term to promote your health.

And that's exactly what Akina is for. Our AI-based training software supports you with therapeutic training at home. Regardless of whether you have chronic or acute pain, whether it is caused by an injury or illness, or whether it is specific or non-specific pain: We have the right training program for you.

Our interactive software recognizes your movements via your laptop's camera and gives you valuable feedback in real time. Your physiotherapist can track your progress or deficits via our platform and give you additional tips to make your treatment even more effective. But that's not all: you can indicate your pain sensation after each training session - changes in your perception are recorded and the training intensity can be further adapted to you. 

We are aware that not only the body but also the mind plays an important role in treatment. That's why our training program is supplemented by stress-reducing mindfulness meditations and knowledgeable content.

Have we sparked your interest? Sign up for our newsletter using the button below and try Akina for yourself soon!