Pharmacologic Management of Low Back Pain

Abstract

Chronic back pain is a complex process and similar to how each patient has a very individualized disease process the treatment regimen should be similarly individualized. There are several different medication classes, each with a unique mechanism of action that can assist the practitioner in targeting a specific aspect of a patient's pain. The goal of this chapter will be to provide an adequate overview of the different medication classes while providing enough drug-specific information to guide the practitioner in selecting and developing an adequate multimodal analgesic regimen. When designing an analgesic regimen, an emphasis should be placed using a modified stepwise approach similar to the World Health Organization's analgesic ladder. There should be a focus on a multi-modal analgesia utilizing nonopioid medications for chronic pain. Patient-specific factors should always be considered when choosing class, strength, dosage form and possible adjuvant medications. Just like patients, no analgesic regimen should be exactly the same.