The most common types of mild to moderate neck pain usually respond well to self-care within 3 to 4 weeks. If neck pain continues, your doctor might recommend other treatments. Your doctor might prescribe stronger pain medicine than what you can get over-the-counter, as well as muscle relaxants, steroids, anti-convulsants, and possibly antidepressants for pain relief.
Nonsteroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen (Motrin, Advil) and naproxen (Aleve) are front-line drugs in the treatment of neck pain because they reduce both pain and inflammation. Like Tylanol, many NSAIDs are available over-the-counter, but they also need to be taken carefully. NSAIDs can have some serious side effects, such as gastrointestinal bleeding, ulcers, and kidney damage, especially when used for long periods of time. NSAIDs have also been linked to an increased risk of heart attack or stroke.
Because of their increased risks, opioids are not a first-line therapy for pain. Opioids such as codeine (contained in Tylenol with codeine), hydrocodone (contained in Vicodin and Lortab), and oxycodone (such as OxyContin, and contained in Percocet and Percodan) can provide significant relief when neck pain is particularly intense and other non-narcotic pain medications aren’t sufficient for pain relief. Although opioids are effective for pain, they should be used with caution because they can lead to dangerous side-effect . These prescription painkillers also have the potential for abuse and addiction.
Steroids such as prednisone (Deltasone, Orasone, Sterapred) work by reducing inflammation. Although they can be taken orally, steroids given for neck pain are sometimes delivered directly to the spine via an injection to the area. Research shows that steroid injection does relieve neck pain over the short term, although its effectiveness for chronic pain is unclear. The most common side effects of short-term oral steroids are an increase in blood sugars, water retention and stomach ulcers. Side effects of oral steroids, which are not generally used, include weight gain, and, less often, high blood pressure and osteoporosis.
Muscle relaxants such as Baclofen can calm muscle tightness, and some research suggests they can relieve neck pain within the first few days of an acute injury. When using these drugs, watch out for side effects such as drowsiness, dependence, and urinary retention. These drugs are best used short term under a doctor’s guidance.
Nonnarcotic Methods of Pain Management
Pain and Self-reported Swollen Joints Are Main Drivers of Patient-reported Flares in Rheumatoid Arthritis: Results from a 12-month Observational Study
List of authors. Nanna B. Finnerup, M.D.
June 20, 2019 N Engl J Med 2019; 380:2440-2448DOI: 10.1056/NEJMra1807061
Advances in the diagnosis and management of neck pain
BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3221 (Published 14 August 2017)Cite this as: BMJ 2017;358:j3221
Steven P Cohen, professor1 2, W Michael Hooten, professor3
Although they are approved by the FDA to treat seizures, anticonvulsant drugs such as gabapentin (Neurontin), carbamazepine (Tegretol), and pregabalin (Lyrica) can be used to treat neck pain. How exactly anticonvulsants work on neck pain is unknown, but they are believed to affect the way the brain perceives pain. Side effects include dizziness, sleepiness, vision problems, and vomiting.
Antidepressant medications are used off-label to treat chronic pain, especially nerve pain. Examples include amitriptyline and nortriptyline may help with chronic pain and with sleep. It may take several weeks to see an effect. Side effects include drowsiness, dry mouth, constipation, and urinary retention.
Dr. Hong’s experience with treating neck pain using all of these tools allows Denver Pain Management Clinic to treat neck pain of all varieties and degrees of severity. When choosing a pain management Physician to treat your neck pain, it is important to know that your provider has experience prescribing all of the classes of drugs described here, as well as being up to date on the latest research and newest pain relieving medications on the market.