Lumbosacral Spine Sprain/Strain Injuries Medication

  • Author: Andrea Radebold, MD; Chief Editor: Craig C Young, MD   more...
 
Updated: Feb 28, 2010
 

Medication Summary

The goal of pharmacotherapy is to reduce patient morbidity and prevent complications. In acute injuries, pharmacotherapy should usually not exceed 6 weeks of treatment.

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Muscle relaxants

Class Summary

In the acute phase, muscle relaxants (IM injection or tablets) help to treat muscle spasms and facilitate light physical therapy.[12] However, muscle relaxants have not been shown to shorten or alter the course of the injury process.

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Methocarbamol (Robaxin)

 

Exact mechanism in humans not known. May be due to general central nervous system (CNS) depression. Has no direct action on contractile mechanism of striated muscles, the motor endplate, or the nerve fiber. Indicated as an adjunct to rest, physical therapy, and other measures for the relief of the discomfort associated with acute pain and painful musculoskeletal conditions.

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Nonsteroidal anti-inflammatory drugs (NSAIDS)

Class Summary

NSAIDs are generally used to treat muscle pain in the acute and maintenance phases of treatment. These drugs usually have anti-inflammatory, analgesic, and antipyretic activities. The ability of NSAIDs to inhibit prostaglandin synthesis may be involved in the anti-inflammatory effect; these agents are indicated in the acute and maintenance phase of the pain treatment for lumbosacral injuries.

Selective cyclooxygenase-2 (COX-2) inhibitors are generally not recommended as first-line treatment.

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Diclofenac (Voltaren)

 

Has anti-inflammatory, analgesic, and antipyretic activities. Used to treat acute and continuous pain. In general, patients should be maintained on the lowest dosage of diclofenac that is consistent with achieving a satisfactory therapeutic response.

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Ibuprofen (Ibuprin, Advil, Motrin)

 

Drug has anti-inflammatory, antipyretic, and analgesic activities. Mode of action not known. However, ability to inhibit prostaglandin synthesis may be involved in anti-inflammatory effect. Smallest dose that yields acceptable control of pain should be employed. A therapy longer than 3-6 months may result in gastrointestinal bleeding or ulcers; long-term therapy must be closely observed.

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Contributor Information and Disclosures
Author

Andrea Radebold, MD  Research Associate, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Andrew D Perron, MD  Residency Director, Department of Emergency Medicine, Maine Medical Center

Andrew D Perron, MD is a member of the following medical societies: American College of Emergency Physicians, American College of Sports Medicine, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Russell D White, MD  Professor of Medicine, Director of Sports Medicine Fellowship Program, Medical Director, Sports Medicine Center, Head Team Physician, University of Missouri-Kansas City Intercollegiate Athletic Program, Department of Community and Family Medicine, University of Missouri-Kansas City School of Medicine, Truman Medical Center Lakewood

Russell D White, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Family Physicians, American Association of Clinical Endocrinologists, American College of Sports Medicine, American Diabetes Association, and American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Jon B Whitehurst, MD  Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital

Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America

Disclosure: Nothing to disclose.

Chief Editor

Craig C Young, MD  Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Sports Medicine Fellowship Director, Medical College of Wisconsin

Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, and Phi Beta Kappa

Disclosure: Nothing to disclose.

References

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