Return to
the Emergency Department for persistent or worsening pain, development of
fever, weakness or numbness in the lower extremities, incontinence of urine or
stool, or any new or concerning symptoms.
A pulled or
strained muscle in the back can be extremely painful, but in most cases will
resolve completely within 2 weeks. Pain
can be managed by taking anti-inflammatory medications like Ibuprofen (also
known as Motrin or Advil) or Naproxen (also known as Aleve). You can also take Acetaminophen (also known
as Tylenol). These medications work by
reducing the inflammation around injured muscles in the back. You may also have been prescribed a muscle
relaxant medication, such as Cyclobenzaprine (also known as Flexeril) or Valium
(also known as Diazepam). These
medications work by decreasing muscle spasm that often accompanies injury to a
muscle in the back. It is important that
you NOT DRIVE OR OPERATE HEAVY MACHINERY OR EQUIPMENT WITHIN 8 HOURS OF TAKING
THESE MEDICATIONS.
You may
also have been prescribed a stronger opioid pain medication, such as
Hydrocodone (also known as Norco) or Oxycodone (also known as Percocet) for
more severe pain. It is important that
you only use these medications for pain that is not responding to anti-inflammatory
medications, such as Ibuprofen or Naproxen.
You should wait at least 1 hour after taking anti-inflammatory
medications to see if they are effective before taking these stronger opioid
medications. These opioid medications
contain Acetaminophen, so DO NOT TAKE ACETAMINOPHEN (TYLENOL) IF YOU WERE
PRESCRIBED OPIOID MEDICATIONS. It is
important that you NOT DRIVE OR OPERATE HEAVY MACHINERY OR EQUIPMENT WITHIN 8
HOURS OF TAKING THESE MEDICATIONS. These
medications may also cause constipation, so be sure to drink plenty of fluids
and consider using over-the-counter laxatives, such as Metamucil or Docusate,
if you develop constipation.
Remember to
continue using simple measures like applying an ice pack to painful areas. The cold can help decrease swelling
associated with inflammation. Swelling
is common in the initial days after an injury to the back, but over time muscle
stiffness can develop. Heat can help
with muscle stiffness, so applying a heating pad can be beneficial. Be sure to not leave a heating pad on
overnight, as this can result in burns.
Complete
bedrest is no longer recommended in the setting of back pain, but you should
avoid all heavy lifting. Don’t sit or
lie down for prolonged periods, because this actually increases the strain on
your back. Long term you may benefit from
physical therapy and stretching programs including yoga. Many back pain patients benefit from a diet
and exercise regimen including weight loss.
Please note that if your condition worsens or changes significantly, we would like to see you again. You may return at any time if you have further concerns. Following up with your primary care provider and/or specialist as indicated is important for your overall health and wellness.
https://orthoinfo.org/globalassets/pdfs/2017-rehab_spine.pdf
Please note, it is no longer my personal practice to prescribe opioid pain medications in the treatment of back pain from musculoskeletal and atraumatic etiologies. I have included safety precautions in the discharge instructions for your review. As with all templates on this site, it is important that you review what is documented, and adapt it so as to keep in line with all appropriate practice recommendations relevant to the site where you work.
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