¿Cuál es el mejor tratamiento para aliviar el dolor de espalda?

¿Cuál es el mejor tratamiento para aliviar el dolor de espalda?

17 de noviembre de 2017

Jamie Belcastro, farmacéutico autorizado

Belmora LLC

Hay muchos tratamientos para el dolor de espalda, entre los que se incluyen pastillas, parches, fajas, compresas o tratamientos tópicos. ¿Cuál es el mejor tratamiento para usted?

 

El dolor de espalda es la segunda dolencia neurológica más común en los Estados Unidos —solo el dolor de cabeza es más común que el de espalda. En un año cualquiera, hasta el 50 por ciento de los adultos padecen de dolor de espalda y el 85 por ciento de las personas menores de 50 años experimentarán al menos un caso de dolor de espalda cada año1-3. 

Un dolor agudo en la zona lumbar (parte inferior de la espalda) dura entre un día y tres meses. Si el dolor dura más, se le clasifica como crónico. Entre las causas comunes de este dolor se encuentran la irritación de un nervio, el padecimiento de artritis ósea o en las articulaciones, radiculopatía lumbar (irritación del nervio ocasionada por discos herniados o dañados) e intrusión ósea (las vértebras pueden desplazarse y ejercer presión en la médula espinal y los nervios)4. Entre otras causas se pueden mencionar cálculos renales, obesidad, tabaquismo, tensión, una mala postura y condiciones inadecuadas para dormir. Sin embargo, la causa más común de un dolor de espalda agudo es la distensión lumbar — una lesión por estiramiento en los ligamentos, tendones y/o músculos de la parte inferior de la espalda. La lesión genera desgarros microscópicos en estos tejidos, lo cual ocasiona dolor e inflamación4.

Tratamiento
La mayoría de los dolores de espalda son un padecimiento autolimitante que se disipa en unos días. El tratamiento más eficaz son los medicamentos antiinflamatorios, los analgésicos tópicos y los ejercicios para fortalecer los músculos, con el fin de restaurar sus funciones de forma adecuada y evitar una reaparición del dolor.

A menudo, se malinterpreta el umbral de dolor. Su umbral de dolor es el punto en el cual su cuerpo experimenta dolor debido a un estímulo interno o externo. Este umbral NO es constante y varía en el transcurso del tiempo e incluso dentro de un mismo día. ¿Por qué? Esto obedece a que su cuerpo experimenta grados de tensión que varían con el tiempo y en un mismo día.

Tratamientos con un agente único
Debido a que el umbral de dolor de su cuerpo es dinámico, es poco probable que usted experimente alivio del dolor de espalda mediante un solo tratamiento. Es necesario recurrir a un enfoque de agentes múltiples, debido a los numerosos nervios y tejidos que se encuentran en la espalda, al igual que a los diversos grados de tensión que se ejercen en la espalda en el transcurso del día.

Medicamentos antiinflamatorios
Un antiinflamatorio idóneo es aquel que tiene una semivida prolongada o de duración de la acción. Las tabletas para el alivio del dolor Flanax son uno de estos agentes. Además, resulta sensato escoger un antiinflamatorio que presente los menores efectos secundarios posibles. De todos los AINE estudiados, el naproxeno (Flanax) es el que mostró el menor perfil de riesgo7.

Analgésicos tópicos
La mayoría de los analgésicos tópicos de venta libre (sin receta médica) informan a los pacientes que deben frotarse directamente con el agente en el área con dolor. Parece que estos analgésicos tópicos alivian el dolor al generar un efecto contrairritante que produce ya sea una sensación de frescura o de ardor. El ingrediente activo más común en productos rubefacientes de venta libre es la capsaicina, un elemento derivado de los pimientos picantes. Una vez que la piel absorbe la capsaicina, la persona que está usando el producto se desensibiliza al dolor, pues se interfiere con los impulsos nerviosos que transmiten sensaciones de dolor al cerebro. Otros productos contienen salicilato de metilo, gaulteria o aceite de eucalipto.

Un analgésico tópico idóneo deberá incluir una combinación de ingredientes activos, tal como el linimento Flanax, el cual contiene capsaicina, mentol y salicilato de metilo.

 


 

 

Cuadro 2

CONSEJOS PRÁCTICOS PARA UNA ESPALDA MÁS SALUDABLE
Estírese antes de ejercitarse o de realizar otras actividades físicas agotadoras.
No se encorve cuando esté de pie o sentado(a).
Utilice sillas con un buen respaldo lumbar.
Utilice zapatos cómodos y de tacón bajo.
Duerma de lado. Siempre duerma en un colchón firme.
No alce objetos pesados y siempre álcelos con las rodillas dobladas.
Deje de fumar. El tabaquismo reduce el flujo sanguíneo en la región lumbar, lo que ocasiona que los discos intervertebrales se degeneren.

Fuente: Instituto Nacional de Trastornos Neurológicos y Accidentes Cerebrovasculares

Compresas frías y calientes 
Si bien no se ha comprobado científicamente que las compresas frías y calientes permiten una recuperación rápida de un dolor de espalda agudo, estas pueden ayudar a reducir temporalmente el dolor y la inflamación. Sin embargo, las compresas no ofrecerán ningún otro beneficio con su uso crónico.

Fajas 
Aunque algunas personas las encuentran útiles, el uso de fajas elásticas anchas y otras prendas con soporte que pueden ajustarse para “retraer” los músculos lumbares y abdominales sigue siendo controversial. Un estudio trascendental reveló que no hay evidencia alguna de que las fajas elásticas y prendas similares reduzcan y/o eviten las lesiones o los dolores de espalda1. 

Reposo en cama 
Las personas con dolor de espalda que continúan con su rutina normal funcionan mejor que aquellas a los que se les ordena reposo en cama (o reposo absoluto). Un informe de Cochrane concluyó lo siguiente: “La recomendación de un reposo en cama es menos eficaz que la recomendación de permanecer activo(a)”12. También se ha relacionado la actividad con una mejoría moderada del dolor y las funciones13. El reposo en cama por sí mismo puede agravar el dolor de espada, ya que reduce el tono muscular y aumenta el riesgo de que se formen coágulos sanguíneos.

Reflexión final
Debido a que el dolor de espalda es un padecimiento recurrente para muchas personas, resulta útil centrarse en su prevención. El ejercicio fortalece los músculos de la espalda y es la forma más eficaz para lograr una recuperación rápida y evitar futuras tensiones musculares. Quizás el mejor ejercicio para prevenir el dolor en la zona lumbar sean las caminatas1,14.

Referencias bibliográficas
1. National Institute of Neurological Disorders and Stroke. Low back pain fact sheet. http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm. Consultada el 8 de enero de 2011.

2. US Spine Care. Facts about back pain. http://www.usspinecare.com/back-pain-facts.html. Consultada el 10 de enero de 2011.

3. Perina D. Back pain, mechanical. http://emedicine.medscape.com/article/822462-overview. Consultada el 10 de enero de 2011.

4. Shiel W. Lower back pain (lumbar back pain). http://www.medicinenet.com/low_back_pain/article.htm. Consultada el 8 de enero de 2011.

 

  1. Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147:478-491.6. Herndon CM, Hutchison RW, Berdine HJ, et al. Management of chronic nonmalignant pain with nonsteroidal anti-inflammatory drugs. Joint opinion statement of the Ambulatory Care, Cardiology, and Pain and Palliative Care Practice and Research Networks of the American College of Clinical Pharmacy.Pharmacotherapy. 2008;28:788-805.7. Trelle S, Reichenbach S, Wandel S, et al. Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ. 2011;342:c7086. doi: 10.1136/bmj.c7086.

    8. Gandey A. All nonsteroidal anti-inflammatory drugs have cardiovascular risks. http://www.medscape.com/viewarticle/735672.

    9. Roelofs PD, Deyo RA, Koes BW, et al. Nonsteroidal anti-inflammatory drugs for low back pain: An updated Cochrane review. Spine. 2008;33:1766-1774.

    10. Lowes R. FDA limits acetaminophen in prescription analgesics. http://www.medscape.com/viewarticle/735738. Consultada el 18 de enero de 2011.

    11. Matthews P, Derry S, Moore RA, McQuay HJ. Topical rubefacients for acute and chronic pain in adults. Cochrane Database Syst Rev.2009(3):CD007403. DOI: 10.1002/14651858.CD007403.pub2. http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD007403/frame.html.

    12. Hagen KB, Hilde G, Jamtvedt G, Winnem M. WITHDRAWN: Bed rest for acute low-back pain and sciatica. Cochrane Database Syst Rev. 2010(6):CD001254.

  2. Vega C. For acute low back pain, staying active may be better than bed rest. http:/medscape.org/viewarticle/724386. Consultada el 10 de enero de 2011.
  3. WebMD. Low back pain – treatment overview. http://www.webmd.com/back-pain/tc/low-back-pain-treatment-overview. Consultada el 10 de enero de 2011.

How to Live with Osteoarthritis

November 28, 2017

Jamie Belcastro, RPh

Belmora LLC

Optimal treatments for longer lasting pain relief!

Osteoarthritis (OA), which is the most common form of arthritis, is a progressive disorder caused by the breakdown of cartilage that cushions the joints. When the cartilage in the joint breaks down the bones come into contact within a joint of the body and this causes the pain and inflammation.1,2 Ultimately this leads to reduced joint mobility, as well as, stiffness, and weakness that can negatively impact an individual’s ability to perform routine tasks and consequently reduce his or her overall quality of life.

Although OA can occur in individuals of any age, its incidence increases with age, especially in those 65 years and older. OA generally occurs in older people since the body’s joints begin to endure the effects of many years of stress and strain.1,2 OA can occur in any joint, but the most commonly affected areas are the joints of the fingers, base of the thumbs, hips, knees, neck, big toes, and lower back.1-5 Without adequate pain relief, OA patients cannot perform activities of daily living and their quality of life diminishes.

Osteoarthritis Risk Factors
OA typically develops slowly and worsens over time, especially if left untreated. Risk factors can be classified as genetic, metabolic, or environmental. Common risk factors associated with OA include the following1- 5:

  • Increased age
  • Gender (more common in women)
  • Obesity
  • Joint injury
  • Genetics
  • Repetitive stress on joints due to certain occupations or sports
  • Bad posture
  • Other medical conditions, such as diabetes or gout

Diagnosing Osteoarthritis
OA symptoms typically develop gradually, with variable severity. The most common signs and symptoms include the following1-5:

  • Pain and stiffness in the affected joint after periods of inactivity such as sleeping or sitting for an extended period
  • Swelling or tenderness in 1 or more joints
  • Limited range of motion
  • Increased pain after exercising or putting pressure on the affected joint
  • Crackling or grinding sensation with joint movement
  • Bone spur formation around the joint

Treating Osteoarthritis 
Although there is no cure for OA, a variety of treatment options can help decrease pain and maintain joint mobility. Typically, the main goal of OA treatment is to improve the patient’s overall quality of life by relieving pain and enhancing joint mobility and function. It is unlikely that a single treatment can keep an OA patient pain free during the entire day.

 

The body’s pain threshold changes during the day, and when the body encounters stress from lifting or undertaking physical activities the stress placed on the affected arthritic joints increases and the pain threshold decreases.

 

Therefore, it is important to have an arthritis treatment that can handle the changes in your pain threshold during the day, so the OA patient can be pain free during the day.
Commonly used oral medications are nonsteroidal anti-inflammatory drugs such as Flanax Pain Reliever Tablets. Topical analgesics such as capsaicin cream are also applied directly to the skin.

 

Flanax Liniment which contains capsaicin, menthol, and methyl salicylate provides a triple action defense to stopping pain. Using the Flanax Pain Reliever Tablets twice daily and applying the Flanax Liniment throughout the day should keep you pain free all-day long.

 

Your physician may also recommend corticosteroid injections for temporary pain relief. To ensure safety and avoid potential drug interactions, always consult your physician or pharmacist before taking any OTC medications, including supplements. Other therapies include physical therapy, transcutaneous electrical nerve stimulation, rest, heat and cold therapy, weight loss, and the use of support devices to take strain off joints, such as canes and splints. In some cases, surgery is warranted.

Living with Osteoarthritis 
Individuals with OA can lead normal and active lives, especially if OA is identified early and treated properly. You can become an active partner in your treatment by:

  • Maintaining a healthy weight to reduce stress on weight-bearing joints
  • Engaging in light regular exercise when appropriate to enhance flexibility and strength
  • Eating a healthy diet
  • Getting sufficient rest and relaxation
  • Developing means to reduce and manage stress
  • Protecting your joints from injury by stretching before any exercise

References:

1. Understanding arthritis. WEBMD website. https://www.webmd.com/arthritis/default.htm Accessed November 27, 2017.
2. Osteoarthritis. Mayo Clinic website. https://medlineplus.gov/osteoarthritis.html Accessed November 27, 2017.
3. What is osteoarthritis? Arthritis Foundation website. www.arthritistoday.org/about-arthritis/types-of-arthritis/osteoarthritis/what-you-need-to-know/osteoarthritis-is.php. Accessed November 27, 2017.
4. Osteoarthritis and you. Centers for Disease Control and Prevention website. www.cdc.gov/Features/OsteoarthritisPlan/. Accessed November 27, 2017.
5. Handout on health: Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. www.niams.nih.gov/Health_Info/Osteoarthritis/. Accessed November 27, 2017.

What is the best treatment for back pain?

November 17, 2017
Jamie Belcastro RPh
Belmora LLC
There are many treatments for back pain, including pills, patches, belts, compresses, and topical treatments. Which is best for you?
________________________________________
Back pain is the second most common neurologic ailment in the United States—only headache is more common. Within a given year, up to 50% of adults suffer from back pain and 85% of people younger than 50 years will experience at least 1 back pain episode each year.1-3

Acute lower back pain (LBP) lasts from 1 day to 3 months; longer durations are classified as chronic. Common causes include nerve irritation, bone and joint arthritic conditions, lumbar radiculopathy (nerve irritation caused by herniated or damaged discs), and bony encroachment (vertebrae can shift, pressing against the spinal cord and nerves).4 Other causes may include kidney stones, obesity, smoking, stress, poor posture, and poor sleeping conditions. Acute back pain’s most common cause, however, is lumbar strain—a stretch injury to the lower back’s ligaments, tendons, and/or muscles. The injury creates microscopic tears in these tissues, causing pain and inflammation.4

Treatment
Most back pain is self-limiting, dissipating within days. The most effective treatment are anti-inflammatories, apply topical analgesics, and muscle-strengthening exercises to restore proper function and prevent recurrence.
The pain threshold is often misunderstood. Your pain threshold is the point at which your body experiences pain due to an external or internal stimulus. It is NOT constant and changes over time and even within a given day. Why? Your body experiences varying degrees of stress over time and even within a day.
Single Agent Treatments
Since your body’s pain threshold is dynamic it is unlikely you will experience back pain relief from a single treatment. A multi-agent approach is necessary given the numerous nerves and tissues that comprise the back and the varying degrees of stress that is placed on your back during the day.

Anti-Inflammatories
The ideal anti-inflammatory is one that has a long half-life or duration of action. Flanax Pain Reliever tablets is one such agent. In addition, it is wise to choose an anti-inflammatory with the lowest side effects. Of all NSAIDs studied, naproxen(Flanax) had the lowest risk profile.7

Topical Analgesics
Most OTC topical analgesics direct the patient to rub the agent directly on the tender area. They appear to relieve pain by causing a counterirritant effect, producing either a burning or cooling sensation. The most common active ingredient in OTC rubefacient products is capsaicin, which is derived from chili peppers. Once the skin absorbs capsaicin, it desensitizes the individual to pain by interfering with neural signals that transmit pain sensations to the brain. Other products contain methyl salicylates, wintergreen, or eucalyptus oil.
The ideal topical analgesic would contain a combination of active ingredients such as Flanax Liniment which contains capsaicin, menthol, and methyl salicylate.

Hot and Cold Compresses
Hot and cold presses are scientifically unproven to provide a speedy recovery from acute back pain, but they can help temporarily reduce pain and inflammation but will not provide any further benefit with chronic use.
Belts
Although some people find them helpful, the use of wide elastic belts and other support garments that can be tightened to “pull in” lumbar and abdominal muscles remains controversial. One landmark study found no evidence that elastic belts and similar garments reduced and/or prevented back injury or back pain.1

Bed Rest
People with back pain who continue their normal routine function better than those assigned to bed rest. A Cochrane report concludes, “Advice to rest in bed is less effective than advice to stay active.”12Activity is also associated with modest improvements in pain and function.13 Bed rest alone may exacerbate back pain because it decreases muscle tone and increases risk for blood clots.

Final Thought
Because back pain is a recurring condition for many, it helps to focus on prevention Exercise strengthens back muscles and is the most effective way to a speedy recovery and preventing future muscle strain. Walking is perhaps the best exercise for preventing LBP.1,14 PT

References
1. National Institute of Neurological Disorders and Stroke. Low back pain fact sheet. http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm. Accessed January 8, 2011.

2. US Spine Care. Facts about back pain. http://www.usspinecare.com/back-pain-facts.html. Accessed January 10, 2011.

3. Perina D. Back pain, mechanical. http://emedicine.medscape.com/article/822462-overview. Accessed January 10, 2011.

4. Shiel W. Lower back pain (lumbar back pain). http://www.medicinenet.com/low_back_pain/article.htm. Accessed January 8, 2011.

5. Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147:478-491.

6. Herndon CM, Hutchison RW, Berdine HJ, et al. Management of chronic nonmalignant pain with nonsteroidal anti-inflammatory drugs. Joint opinion statement of the Ambulatory Care, Cardiology, and Pain and Palliative Care Practice and Research Networks of the American College of Clinical Pharmacy. Pharmacotherapy. 2008;28:788-805.

7. Trelle S, Reichenbach S, Wandel S, et al. Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ. 2011;342:c7086. doi: 10.1136/bmj.c7086.

8. Gandey A. All nonsteroidal anti-inflammatory drugs have cardiovascular risks. http://www.medscape.com/viewarticle/735672.

9. Roelofs PD, Deyo RA, Koes BW, et al. Nonsteroidal anti-inflammatory drugs for low back pain: an updated Cochrane review. Spine. 2008;33:1766-1774.

10. Lowes R. FDA limits acetaminophen in prescription analgesics. http://www.medscape.com/viewarticle/735738. Accessed January 18, 2011.

11. Matthews P, Derry S, Moore RA, McQuay HJ. Topical rubefacients for acute and chronic pain in adults. Cochrane Database Syst Rev. 2009(3):CD007403. DOI: 10.1002/14651858.CD007403.pub2. http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD007403/frame.html.

12. Hagen KB, Hilde G, Jamtvedt G, Winnem M. WITHDRAWN: Bed rest for acute low-back pain and sciatica. Cochrane Database Syst Rev. 2010(6):CD001254.

13. Vega C. For acute low back pain, staying active may be better than bed rest. http:/medscape.org/viewarticle/724386. Accessed January 10, 2011.

14. WebMD. Low back pain – treatment overview. http://www.webmd.com/back-pain/tc/low-back-pain-treatment-overview. Accessed January 10, 2011.

Menstrual Cramps 😭

How to stop your menstrual cramps during the night?
Menstrual cramps can definitely interfere with your sleep. One way to stop your menstrual cramping during the night is to take Flanax Pain Reliever Tablets. Flanax Pain Reliever Tablets have a long half life (duration of action) and will help to stop your menstrual cramps so you can sleep.
#menstrual_cramps

¿Cómo detener tus calambres menstruales durante la noche?
Los calambres menstruales definitivamente pueden interferir con su sueño. Una forma de detener sus cólicos menstruales durante la noche es tomar Flanax Pain Reliever Tabletas. Flanax Pain Reliever Tablets tiene una vida media larga (duración de la acción) y ayudará a detener sus cólicos menstruales para que pueda dormir. #colicosmenstruales

#FLANAX EL ALIVIO QUE DURA MÁS!

TE PROVOCA EL CAFÉ DOLOR DE CABEZA? ☕️

Does coffee cause headaches?

Coffee that has caffeine can be a headache trigger or headache inhibitor. … Before a headache or migraine occurs, the blood vessels in your head tend to enlarge. Caffeine has “vasoconstrictive” properties that cause the blood vessels to narrow and restrict blood flow, therefore sometimes caffeine can aid in head pain relief.
But Flanax Pain Reliever Tablets will always stop your headaches! Take two Flanax Pain Reliever Tablets as soon as you feel the headache and one tablet one hour later.
#dolor_de_cabeza #headaches

¿El café causa dolores de cabeza?
El café que tiene cafeína puede ser un desencadenante de dolor de cabeza o un inhibidor del dolor de cabeza. … Antes de que ocurra un dolor de cabeza o una migraña, los vasos sanguíneos de la cabeza tienden a agrandarse. La cafeína tiene propiedades “vasoconstrictoras” que hacen que los vasos sanguíneos se estrechen y restrinjan el flujo sanguíneo, por lo tanto, a veces la cafeína puede ayudar a aliviar el dolor de cabeza. ¡Pero Flanax Pain Reliever Tablets siempre detendrá tus dolores de cabeza! Tome dos Tabletas de alivio del dolor Flanax tan pronto como sienta el dolor de cabeza y una tableta una hora más tarde. #dolor_de_cabeza

#FLANAX EL ALIVIO QUE DURA MÁS!!

WWW.FLANAXUSA.COM 💙

Migraña Vestibular 😰

Do you have #Vestibular_Migraine? 😰

Vestibular migraine is migraine associated with vertigo or dizziness.
Symptoms are:
1) Current/past history of migraine with or without aura
2) Migraine lasting from 5 minutes to 72 hours
3) Vertigo
4) Vertigo that occurs from a change in your head position
5) Nausea

Use #Flanax Pain Reliever Tablets to stop vestibular migraine! Take two Flanax Pain Reliever Tablets as soon as you feel the migraine and one tablet one hour later.

#Vestibular_migraine #vertigo

¿Tiene Migraña_Vestibular?

La migraña vestibular es una migraña asociada con vértigo o mareos. Los síntomas son:
1) Historia actual / pasada de migraña con o sin aura
2) Migraña que dura de 5 minutos a 72 horas
3) Vértigo
4) Vértigo que ocurre por un cambio en la posición de su cabeza
5) Náuseas
¡Utilice Flanax Pain Reliever Tablets para detener la migraña vestibular!
Tome dos Tabletas de alivio del dolor Flanax tan pronto como sienta la migraña y una tableta una hora más tarde. #Vestibular_migraine #vertigo

FLANAX EL ALIVIO QUE DURA MÁS!!