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Many pain medications can be used for spine-related pain in older adults

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Spinal cord injury is on the rise in the elderly. While medications play an important role in pain management, their use is limited in geriatric patients due to reduced liver function and kidney function, medical problems and polypharmacy (use of multiple medications at the same time to treat the condition. health).

Now a new research study has found acetaminophen is safe in the elderly, but non-steroidal anti-inflammatories (ibuprofen) may be more effective for spinal-related pain. Short-term non-steroidal anti-inflammatory drugs should be used in small doses with gastrointestinal prevention while corticosteroids show the least evidence to treat back pain.

In addition to the nerve hot medicines (gabapentin and pregabalin) can be used internally great peoplewith caution to the bone as well kidney function. Newer antidepressants (duloxetine) than older ones (nortriptyline) may help with spinal-related pain, with a focus on the possibility of sedation and dizziness. Some muscle relaxants (baclofen and tizanidine) can be used in the elderly, re-calculating kidney and liver function. Opioids have limited use in spinal cord injury, but they can be used with caution in cases where they do not respond to treatment.

“Most seniors face hardship though low back pain at times, the stress is enough to see their doctor. Our results provide a helpful treatment guide for physicians to use for back pain in the elderly who may have complex medical history”said relevant author Michael D. Perloff, MD, Ph.D., assistant professor of biology at Boston University School of Medicine (BUSM) and psychiatrist at Boston Medical Center.

The researchers reviewed the literature to evaluate the evidence-based treatment regimens used for spinal cord injury in the elderly, with a focus on drug and drug therapy. They also offer their advice on safe and effective doses.

Among their research:

  • Gabapentin and pregabalin can cause dizziness or difficulty walking, but it can have some benefit for neck and back pain (like sciatica) in the elderly. They should be used in small doses with minimal bone resorption.
  • Some muscle relaxants (carisoprodol, chlorzoxazone, cyclobenzaprine, metaxalone, methocarbamol, and orphenadrine) are avoided by older adults due to the risk of fractures and falls. Some (tizanidine, baclofen, dantrolene) may help neck and back pain, with the most evidence for tizanidine and baclofen. These should be used in small doses, avoiding tizanidine with liver disease and reducing baclofen intake with kidney disease.
  • Older antibiotics are avoided in the elderly because of their effectiveness, but nortriptyline and desipramine may be better tolerated for neck and shoulder pain in lower doses. In general, newer antidepressants (i.e. duloxetine) have a better profile and improved effectiveness for spinal cord injury.
  • Tramadol can be tolerated internally manya manya, but it is dangerous to calm down, nausea, and constipation. It can be used in small doses after alternative medications have failed and works well in combination with acetaminophen. Opioids are avoided because of their impact and risk of death, but opioid deficiency can be helpful for chronic pain with the care of hospitalized patients.

According to the researchers, additional treatment, physical therapy, injections and surgery all have a place to help the elderly with spinal cord injuries. “Medications used in the right amount, for diagnosis, adaptation to pre-existing health problems can result in the best use of treatment for the spine. heat“said first author Jonathan Fu, who graduated with a 2022 degree from BUSM.

These findings appear online in the journal Medicine & Aging.


Question & A: More ideas to help treat back pain


Learn more:
Jonathan L. Fu et al, Pharmacotherapy for Spinal Cord Injury in Adults, Medicine & Aging (2022). DOI: 10.1007 / s40266-022-00946-x

hintMultiple painkillers can be used for spinal related pain in the elderly (2022, June 28) Retrieved 28 June 2022 from https://medicalxpress.com/news/2022-06-pain- medications-spine-related-older- manya.html

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