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Medicines for Your Injury


Group of Pills

When people visit the office of the medical doctor, often in the back of their mind they expect that the doctor will prescribe a pill to solve all of their problems. When talking about injuries to the neck, the back, the shoulder, or the knee, medicines are not the solution to the problem. Sometimes medicines can help with an injury, but they are almost never a complete answer to a problem. For all the medicines discussed here, different people will respond differently, so if a medicine does not seem to work properly, talk to your doctor.

Clearly, the most important problem with injuries is the pain. Considering how important a problem pain is, we certainly would like to know more about it. There have been some improvement in the last few years in the medicines used to control pain, but these are still limited. None of the medicines available in pill form do anything to treat the source of spinal or other injury pain. Certain medicines are helpful in other ways, including indirectly affecting the source of the pain.

Types and uses of medicines

Anti-inflammatory

This group of medicines is popular and includes both prescription and non-prescription medicines. The full medical name of this group is non-steroidal anti-inflammatory agents (NSAIDs). This includes the non-prescription Motrin-IB, Aleve, and ibuprofen, and the prescription Naprosyn, Tolectin, Daypro, and many more. Until recently, the medicines in this group all acted the same, doing the same things and having the same side effects. The differences mostly were in how strong they were, how many times per day they needed to be taken to cause the same good effects, and how often they caused the same side effects.

More recently Vioxx, Bextra, and Celebrex were invented. These had different problems, and Vioxx was taken off the market.

The most important effect of this class of medications, beyond pain relief, is the anti-inflammatory action. In response to some types of problems, especially arthritis, the body produces a complicated series of reactions, which include redness, fluid, and warmth in the area. This is called inflammation. Inflammation appears to be important in some injuries, but is not important in all injuries. Recent work has demonstrated that inflammation is not important in tendon injuries. One recent article about this is found in:  Sports Medicinedemonstrating no inflammation in chronic Achilles tendon injuries.

Inflammation is also not important in spinal injuries that do not involve the disc.

One characteristic of these medications that is confusing, even to doctors sometimes, is the "muscle relaxant" property. There are two completely separate types of muscles in the body. One type is the skeletal muscle, the muscles in the arms, legs, neck, and back, for example. The other type of muscle is the smooth muscle, found only in the internal organs like the stomach. Medicines act differently on these two types of muscles. The anti-inflammatory medicines relax smooth muscles, which makes them additionally helpful for women's menstrual cramping, but do not relax skeletal muscles, so they do not help the muscle spasm from injuries. There is another group of medicines, discussed below, which do relax skeletal muscles.

Doctors tend to like to prescribe these medicines for painful conditions because they are never addictive, and they do relieve pain.

Muscle Relaxant

This group of medicines so far is prescription only. Unlike the anti-inflammatory medicines, the medicines in this group are very different from each other. They do all relax the skeletal muscle spasm seen after an injury. All of them work through the nervous system and not on the muscles directly. These medicines also all tend to make you sleepy.

The most common medicine in this group is Flexeril, also known by the generic name cyclobenzaprine. This is one of the most likely to make you sleepy, and is also completely not addictive. Other medicines from this group include Robaxin, Soma, Parafon Forte, and several more. You may respond differently to the different medications in this group.

Pain Medications

Pain medications only relieve pain for the time they are working. These include Tylenol, anti-inflammatory medicines, and various narcotic medications. They do nothing to help your problem in the long term, but can be used to make life bearable, especially at the beginning of an injury when the pain is new. All pain medicines have problems with long term use for at least some people.


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Last modified Fri, 17 Jun 2005
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