Lumbar (Intervertebral) Disk Disorders Medication
- Author: Jere F Baldwin, MD; Chief Editor: Rick Kulkarni, MD more...
Medication Summary
The goals of therapy are to reduce pain and inflammation.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Class Summary
These agents are used most commonly for the relief of mild to moderately severe pain. Although effects of NSAIDs in the treatment of pain tend to be patient specific, ibuprofen usually is the DOC for initial therapy. Other options include flurbiprofen, ketoprofen, and naproxen.
Ibuprofen (Ibuprin, Advil, Motrin)
Usually DOC for treatment of mild to moderately severe pain if no contraindications.
Ketoprofen (Oruvail, Orudis, Actron)
Used for relief of mild to moderately severe pain and inflammation. Administer small dosages initially to patients with small body size, to elderly persons, and to those with renal or liver disease. Doses higher than 75 mg do not increase therapeutic effects. Administer high doses with caution, and closely observe patient for response.
Flurbiprofen (Ansaid)
May inhibit enzyme cyclooxygenase, which, in turn, inhibits prostaglandin biosynthesis. These effects may be mechanism of its analgesic, antipyretic, and anti-inflammatory activities.
Naproxen (Anaprox, Naprelan, Naprosyn)
Used for relief of mild to moderately severe pain. Inhibits inflammatory reactions and pain by decreasing activity of enzyme cyclooxygenase, causing decrease in prostaglandin synthesis.
Gregory DS, Seto CK, Wortley GC, Shugart CM. Acute lumbar disk pain: navigating evaluation and treatment choices. Am Fam Physician. Oct 1 2008;78(7):835-42. [Medline].
Deen HG Jr. Diagnosis and management of lumbar disk disease. Mayo Clin Proc. Mar 1996;71(3):283-7. [Medline].
Deyo RA. Diagnostic evaluation of LBP: reaching a specific diagnosis is often impossible. Arch Intern Med. Jul 8 2002;162(13):1444-7; discussion 1447-8. [Medline].
Jarvik JG, Hollingworth W, Martin B, et al. Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial. JAMA. Jun 4 2003;289(21):2810-8. [Medline].
Jensen MC, Brant-Zawadzki MN, Obuchowski N, et al. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. Jul 14 1994;331(2):69-73. [Medline].
Carragee E. Surgical treatment of lumbar disk disorders. JAMA. Nov 22 2006;296(20):2485-7. [Medline].
Deyo RA, Gray DT, Kreuter W, et al. United States trends in lumbar fusion surgery for degenerative conditions. Spine. Jun 15 2005;30(12):1441-5; discussion 1446-7. [Medline].
Dullerud R, Nakstad PH. CT changes after conservative treatment for lumbar disk herniation. Acta Radiol. Sep 1994;35(5):415-9. [Medline].
[Best Evidence] Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT): a randomized trial. JAMA. Nov 22 2006;296(20):2441-50. [Medline].
Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT) observational cohort. JAMA. Nov 22 2006;296(20):2451-9. [Medline].
Frost H, Lamb SE, Doll HA, et al. Randomised controlled trial of physiotherapy compared with advice for low back pain. BMJ. Sep 25 2004;329(7468):708. [Medline].
Gilbert FJ, Grant AM, Gillan MG, et al. Low back pain: influence of early MR imaging or CT on treatment and outcome--multicenter randomized trial. Radiology. May 2004;231(2):343-51. [Medline].

