Neck pain medications

The most common types of mild to moderate neck pain usually respond well to self-care within two or three weeks.Along with rest and physical therapy, medication is often one of the first ways to treat neck pain.If neck pain persists, your doctor might recommend other treatments. There are many different drugs available, and which one to use will depend on the source of your neck pain.

Medications

Your doctor might prescribe stronger pain medicine than what you can get over-the-counter, as well as muscle relaxants and tricyclic antidepressants for pain relief.The various classes of medications are generally prescribed by the physicians. These are -

Opioids 

An opioid may be prescribed for more severe neck pain that can't be controlled using acetaminophen or NSAIDs alone. Opioids work by interfering with the brain's normal processing of pain signals. Some of the medications in this category are combination drugs that include acetaminophen or aspirin, which also has anti-inflammatory properties. Dosing must be carefully monitored because the body can develop a strong physical dependence on them over time. Side effects include drowsiness, dizziness, and nausea.

Drugs in this category include:

• Codeine
• Fentanyl
• Hydrocodone
• Methadone
• Morphine
• Oxycodone

 NSAIDs and Acetaminophen

Nonsteroidal anti-inflammatory drugs, or NSAIDs, like ibuprofen (such as Advil) and naproxen (such as Aleve) relieve pain and reduce swelling by inhibiting the body's inflammatory response. However, side effects include gastric bleeding, stomach pain, longer time for blood clotting if you are bleeding, hypertension, and fluid retention.

Acetaminophen (such as Tylenol) is effective as a pain reliever, but will not improve inflammation, the source of neck pain due to conditions like arthritis of the joints of the vertebrae.

Muscle Relaxants

These medications help relieve neck pain caused by muscle spasms and are most appropriate for short-term use. According to the U.S. Food and Drug Administration, muscle relaxants lose their effectiveness after about two weeks. Some are habit-forming and cause side effects, like drowsiness, dizziness, and confusion, which can prevent you from thinking clearly and safely driving a car or operating machinery.

Drugs in this category include:

• Carisoprodol
• Cyclobenzaprine
• Diazepam
• Methocarbamol
• Tizanidine

Neuropathic and Nerve-Blocking Medications 

For neck pain caused by a pinched nerve or nerve disorder, relief may come from antidepressants, anticonvulsants, and nerve blockers — medications that work by interfering with the way that the brain receives or interprets pain signals or by blocking the pain signals being sent from an irritated nerve. Side effects for antidepressants and anticonvulsants include anxiety, restlessness, drowsiness, dry mouth, and weight gain; anesthetics can cause dizziness, drowsiness, and nausea.

Drugs in these categories include:

• Antidepressants, such as amitriptyline, duloxetine, escitalopram, imipramine, fluoxetine, nortriptyline, paroxetine, sertraline , and venlafaxine.

• Anticonvulsants, such as gabapentin, levetiracetam, pregabalin, phenytoin and topiramate.

• Nerve-blocking medications, such as local anesthetics bupivacaine, lidocaine, and novocaine, and primary neuron blockers like over-the-counter pepper creams and the high-potency capsaicin prescription cream.

Steroids 

Steroids are strong anti-inflammatory hormones used to ease inflammation pain. Steroids must be used with extreme caution because they can have troubling side effects if taken for longer than a week; they are known to promote osteoporosis, inhibit the immune system, cause fluid retention and swelling, and increase appetite and blood sugar levels.

Drugs in this category include:

• Dexamethasone
• Methylprednisolone
• Prednisolone 

Botulinum Toxin

The FDA has also approved the use of botulinum toxin type A (Botox) and botulinum toxin type B (Myobloc) for treating neck pain caused by severe muscle spasms. Both work by partially paralyzing the involved muscles. It can take 3 to 10 days before patients begin to feel relief, but relief may last for 4 months. Side effects may include more serious paralysis of those muscles than desired and difficulty swallowing, but both are temporary.

Therapy

• Physical therapy. A physical therapist can teach you correct posture, alignment and neck-strengthening exercises, and can use heat, ice, electrical stimulation and other measures to help ease your pain and prevent a recurrence.

• Transcutaneous electrical nerve stimulation (TENS). Electrodes placed on your skin near the painful areas deliver tiny electrical impulses that may relieve pain.

• Traction. Traction uses weights, pulleys or an air bladder to gently stretch your neck. This therapy, under supervision of a medical professional and physical therapist, may provide relief of some neck pain, especially pain related to nerve root irritation.

• Short-term immobilization. A soft collar that supports your neck may help relieve pain by taking pressure off the structures in your neck. However, if used for more than three hours at a time or for more than one to two weeks, a collar might do more harm than good.

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Source :  http://www.everydayhealth.com/pain-mangement/neck-pain/medications-for-neck-pain.aspx

                   http://www.mayoclinic.org/diseases-conditions/neck-pain/basics/treatment/con-20028772