Patient Information Resources

Centre for Orthopaedics
Suite 10-33/34/35 Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road
Singapore, 329563, Singapore
Ph: (65) 6684 5828
Fax: (65) 6684 5829

Child Orthopedics
Pain Management
Spine - Cervical
Spine - General
Spine - Lumbar
Spine - Thoracic

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Is there any kind of standard recipe for medications used to treat back pain? A support group of people with chronic back pain (myself included) were having dinner and comparing notes. We discovered there was a different drug or amount of drug taken for pain relief by every single one of us. How is this all figured out?

Getting a handle on what kind of pain medications work best for back pain is not an easy task. There isn't a one-pill-fits-all or one-dose-for-all that guides physicians prescribing medications. They do rely on the drug companies to give them an idea of what works best for the average patient based on research done during the development and testing of the drug. But no matter where or how the research is done, there are just so many variables to consider and compare. Does the patient have back and leg pain or just back pain? Does the patient take the prescribed drug for four weeks? Six weeks? Longer? Researchers try to look at all the studies and combine results for a better understanding of effects. But according to pain research done in Europe, the design of each study isn't similar enough to really allow such a meta-analysis. For example, sometimes patients are given drug combinations rather than a single drug. The dosage might be increased until it reaches a point where it's effective and the side effects are tolerable or patients may be given the same dose from day one. There are other confounding factors. Patients may stop taking the drug and withdraw from the study for any number of reasons. It could be they experienced no pain relief or there might have been unpleasant side effects, so the patient(s) quit taking the medication. The data from discontinuation rates and patient withdrawals makes it difficult to compare one study to another. And each patient presents with unique features. Age, sex (male or female), weight, and activity level (metabolism) are important factors. Location of pain, type of pain, and intensity of pain are also all taken into consideration when choosing a drug and prescribing dosage. Even if you all went to the same physician, it's possible there would be a wide range of differences in how you are treated based on all these (and probably other) individual factors.


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