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Bad back.
Ibuprofen works well but I could do with more than the permitted 3 doses a day.
Is there an alternative anti-inflammatory I can safely take in conjunction with Ibuprofen?
I don't want to go to the doc yet, but will if it drags on.
Firstly what’s wrong with your back ?
Slip disc/lower back pain/ middle back pain etc ?
Have you tried some gentle stretch exercises? Mkensie book look on Amazon will help you.
Is it bad all the time/when you wake up etc ?
Naproxen will be your friend but it’s only available on prescription, though if you look at period pain relief tablets it contains naproxen…
Good luck
as above, (also as a long term back sufferer) although anti inflammatory medicine does help you manage the pain, look at the source of the pain and what can be done about that. Stretches (very specific ones for my issue) helped me immeasurably and i have learned to control the symptoms with care and stretches, with occasional pain relief and ibuprofen.
I had a chronic bad back for almost ten years caused by an injury sustained at work. The doctor weighed me and re-calculated the maximum dose of ibuprofen I was allowed per day. This made a significant difference on the days where things were getting bad. Might be worth asking. I feel for you. Back pain is miserable.
Lower. It felt a little sore Saturday morning (didn't stop me going for a run). Bending to dry my feet out of the shower something painful occured and since then bending down and been a no-no. Fine first thing in the morning if I'm careful, gets progressively worse during the day.
Lying flat on my back reduces pain to zero.
Ibuprofen really helps a lot. I sense that if I could take a dose before bed it would de-inflame things and speed up healing through the night when the load is off it. Three doses doesn't really allow that.
I've taken Naproxen for a sore knee in the past, I would guess that would work fine but I really don't want to bother a doctor unless it drags on.
I was wondering if there's some cream that can be rubbed in that delivers the anti inflammatory to the magic spot without dosage limits?
I found changing my diet to massively reduce my intake of meat, fish, eggs and, particularly, dairy made a huge impact on inflammatory pain (in my case back, knees, shoulders, hands and a dodgy elbow).
I was maxed out on Ibuprofen every day just to be able to keep on my feet. Rarely take any now.
You can take paracetamol with ibuprofen. It will reduce pain but not have much effect on inflammation. Recent research I've read about (but don't know the validity of) suggested that the body's natural inflammation response may actually be helpful and that paracetamol was preferable to anti-inflammatories.
The reason for the limit on ibuprofen, which also applies to other NSAIDs like naproxen, is mainly the risk of damage to your digestive tract. I took naproxen (prescribed) for about 6 weeks for my back, and didn't have any symptomatic side effects. 4 months later I went to do a routine blood donation and was rejected because my haemoglobin level was low. My GP gave me iron tablets and referred me for investigation into anaemia. This showed no reason why I couldn't produce haemoglobin, therefore I may have been losing it through internal bleeding. Further investigation (by now a year after the Naproxen) showed no source of bleeding, and my haemoglobin was almost back to normal. The conclusion was that I had probably had a stomach ulcer as a result of the Naproxen, and it had subsequently healed. So I now have a prescription for omeprazole, if I need to take ibuprofen, which reduces acidity in the stomach and so mitigates the risk of ulcers.
I have managed my back pain since then with pilates, movement and not spending too long sitting.
Edit having seen your second post; you can get ibuprofen gel that you rub in locally, but my physio says the ibuprofen still gets into your bloodstream and the damage to your digestive tract is via that, not directly from digesting the tablets. I have no idea whether he's correct.
It sounds like a short-term issue for now, so your doc may be able to prescribe a slightly stronger anti-inflammatory for a few days to help it settle. Don't wait until it drags on, this is the point when you will actually benefit in terms of recovery. As Greybeard says, NSAIDs have their downsides, and you don't want to be taking them for weeks.
If you want to stick with ibuprofen, why not alternate with paracetamol for pain relief during the day so you have a dose available at bedtime? Always eat something with ibuprofen, especially if you're taking several doses consecutively.
Maybe ice the bit of your back where you felt it go - a few times a day may help also.
Try to keep moving about gently.
The BNF (uk prescribing guide) suggests 400mg 3 to 4 times a day, increased if necessary to max 600mg 4 times a day. Increasing dose may cause increased risk of damage to the stomach lining, so this shouldn't be a long term approach. Also, 'motion is lotion'- movement is generally difficult to start but improves things, lying still is counterproductive. Adding topical anti inflammatory gel is not recommended on top of max oral dose.
Be aware of red flag symptoms of cauda equina syndrome.
Cauda equina syndrome is a rare and severe type of spinal stenosis where all of the nerves in the lower back suddenly become severely compressed.
Symptoms include:
sciatica on both sides
weakness or numbness in both legs that is severe or getting worse
numbness around or under your genitals, or around your anus
finding it hard to start peeing, can't pee or can't control when you pee – and this isn't normal for you
you don't notice when you need to poo or can't control when you poo – and this isn't normal for you
Cauda equina syndrome requires emergency hospital admission and may require emergency surgery, because the longer it goes untreated, the greater the chance it will lead to permanent paralysis and incontinence.
You want to reduce NSAIDS not increase them, awful medication. See a physio who specialises in back pain.
Diclofenac has been the only thing that has helped me recently but it is now discontinued apparently! Naproxen did nothing for my (not formally diagnosed) SI joint pain.
Voltarol gel contains diclofenac though, maybe worth a try?
After recent reporting about Ibuprofen and a possible link to chronic pain, I've been scared off it, so will try paracetamol in future if I need a distraction from the pain.
I've recently started trying to do simple bodyweight glute moves every couple of hours (typically lunge variations to spare the low back). It seems that keeping the glutes active during a day of sitting really helps. This might be specific to my SI joint issue though.
Sounds like you had a spasm if it went suddenly when bending down, so first priority is keeping mobile and letting it loosen off! Invest in a good ice pack/heat pack that you can strap around your waist, don't be afraid to try kinesio tape (I honestly don't believe the 'science' behind taping but have felt a benefit in the past) and maybe just use paracetamol for the pain?
What @Drac says - go to physio, work your way through your back pain.
That's not the only study - there's a lot of them.
The BNF (uk prescribing guide) suggests 400mg 3 to 4 times a day, increased if necessary to max 600mg 4 times a day.
400 4 times a day would sort me, and *I suspect* cure it. Pushing it to 4 times a day for 2 or three days doesn't seem an insane risk. I think I'll try that.
Clearly I won't be taking anything for more than a couple of weeks.
I'm working on the assumption this is going to last a week or so rather than being my new reality. I'm also working on the assumption that reducing the inflation speeds the healing. It feels to me like Ibuprofen and a night's sleep fixes it, then I aggravate it during the day and then the cycle resumes.
Clearly if this is the beginning of a long term back issue I need to get professionals involved, but I think maxing out on Ibuprofen for a couple of days is a useful experiment.
If I go to the doc they're going to give me two weeks of Naproxin so I don't see this as worse than that.
See if this helps
last time I had an acute lower back spasm, my nice doctor gave me some diazepam as a muscle relaxant. At least enabled me to sleep.
See if this helps
Thanks that's brilliant, I'm doing the knee raises already and they alone help in the short term. I'll try the lot.
Thanks that’s brilliant, I’m doing the knee raises already and they alone help in the short term. I’ll try the lot.
Dont guess as to what the issue is as you could make it worse. Go and see a physio and take Drac's advice.
Yes you can get ibuprofen gels - much better than taking tablets.
Dont guess as to what the issue is as you could make it worse. Go and see a physio and take Drac’s advice.
Yes you can get ibuprofen gels – much better than taking tablets.
I'm in my late 40's. If I went to the pros every time something became randomly sore they'd have to give me my own parking space.
But I do take the point, my back is important to me I use it every day, I won't be shy about getting a doc involved.
I had a chronic bad back for almost ten years caused by an injury sustained at work. The doctor weighed me and re-calculated the maximum dose of ibuprofen I was allowed per day.
Similarly I had an issue (De Quervain's tenosynovitis) and the doctor suggested I take double dose of ibuprofen (ie, four tablets every four hours or whatever it is) for seven days and it worked a treat however I don't think you are meant to take too much of it for too long as it can cause stomach issues.
I’m in my late 40’s. If I went to the pros every time something became randomly sore they’d have to give me my own parking space.
I get that - late 40's here too. Niggles are just niggles and I wouldnt take any drugs. As I have got older I have found that if something requires drugs then it probably is more serious than a niggle. Certainly if you are taking drugs for a week then then its not just going to resolve, or will certainly probably keep coming back unless properly diagnosed and dealt with.
For over the counter Votarol is worth a try imo. I used to get a bad back often and diclofenac (which is in Voltarol) was the best relief.
Clearly if this is the beginning of a long term back issue I need to get professionals involved, but I think maxing out on Ibuprofen for a couple of days is a useful experiment.
My GP told me this was exactly how to take it. Short term as a course, not something long term as a crutch. Totally understand though, I've got a serious back injury and I am often tempted to reach for pills. You can show me as many studies as you like, but there's definitely a time and a place for medication for pain management in my opinion.
My experience is that you should never take advice on exercises to ease back pain from anybody who hasn't done a full examination of it first. A private physio and private chiropractor both declined to do anything with mine until they'd seen x-rays and MRI scans. The NHS physio dismissed the warnings on the MRI report "they all say that" and simply after watching me walk (limp) gave me a list of twisting and bending backwards exercises to do. 2 days later the spinal surgeon who operated on me took a look at what he'd given me and said I was right not to do them as one of them might have led to me spending the rest of my life in a nappy.
For temporary pain relief without drugs a Tens machine can be surprisingly effective. I got a £25 one and became very attached to it.
OP have you considered body weight. The suggested doses are based on the average person. Should you be bigger than average a bigger dose could be appropriate.
I’m in my late 40’s. If I went to the pros every time something became randomly sore they’d have to give me my own parking space.
If it’s been going on for a few weeks then a physio will be a big help. It’ll help you get through your 40s without so much discomfort. I’ve been a few times for physio work for my back, neck and shoulder.
There could be so many causes of that back pain, but it sounds like the result is a back spasm - so all the muscles have gone really tensed up. I had that when I bulged a few discs in my back - I worked through that with physio (after an MRI scan) and a cortisol injection at the local hospital.
The short term advice from the doc was to use pain killers to help with the back spasms - I was prescribed a 2 week course of codeine and diclafenac. It got the spasms under control and I eased off them as much as I could. It took a long time to get in a better place for sport and cycling tbh - if I’d paid to go private it would have been a lot quicker than waiting for diagnosis and treatment on the NHS. But they sorted it in the end to be fair.
So personally if you’re adamant you don’t want to go to the doctor or a physio I wouldn’t increase the ibuprofen - I’d get some over the counter co-codamol. It’ll be 8mg codeine / 509mg paracetamol. Try that for 3 or 4 days. If at the end of that it hasn’t eased I’d go to the doctors.
OP have you considered body weight. The suggested doses are based on the average person. Should you be bigger than average a bigger dose could be appropriate.
Yes I have. I'm 6'1 and the recommended max is safe for 12yps. I can't find a chart of safe doses online but the data I can find suggests 3200mg in 24 hours is ok. Taking one more a day I'd be half that but 33pc over the max on the packet.
That's all consistent with this excellent post from this thread:
"The BNF (uk prescribing guide) suggests 400mg 3 to 4 times a day, increased if necessary to max 600mg 4 times a day"
Ironically it's time for my second dose today and my back feels good so I'm now considering skipping it. 🙂
I'll say Volterol gel is really good, and it's 'localised' - we always have some in just in case.
400 4 times a day would sort me, and *I suspect* cure it.
On my experience, it won't 'cure' it. What it might do is stop it spasming so that you can move it, which is the first step in curing it.
I’m working on the assumption this is going to last a week or so rather than being my new reality. I’m also working on the assumption that reducing the inflation speeds the healing.
I am dubious about both those assumptions. Reducing inflammation may enable you do stuff to speed the healing, it won't do any healing directly. I'm 20 years on from where you are and it hasn't gone away. Once you get mobility back, look into how you can avoid a gradual deterioration and recurrence. Take advice, but things that are likely to help are if you spend a lot of time sitting, stand if you can, and do some exercise to strengthen the muscles that support the spine. Don't just assume it's a one off, or you'll end up in your 60's with it being a potentially permanent limitation.
One thing to note about ibuprofen, is it's pretty hard an the digestive system so shouldn't be taken long term orally in high doses, I forget if it's the liver or kidneys that it's hard on.
I only know as I was in hospital one the time for appendix and they made me go back on the codine after so many (small) doses of ibuprofen, so I asked the consultant why they were pushing opiates on me when the ibuprofen seemed to work better for post-op pain.
I was heavily dependent on dichlophenac after a nasty injury at work in 2008, it was great, but the risk was you could do damage without realising it because they were so strong. As said, Volterol contains it, over the counter meds these days (didn't realise dichlophenac was not readily issued by docs these days).
Another thing that helped me at home was my Homedics shiatsu massager, especially after work shifts, with or without the heat option.
But things dramatically changed for me around 2017, around the time I started cycling more for fitness. It may have been complete coincidence, but in spring that year I began randomly trying to do the 2min plank challenge and very quickly my lower back went from being a daily nag to something that just nags every now and again these days. I used to use the shiatsu machine 6+ times a day, I've used it ~6 times in five years.
MRIs are pretty hopeless as a diagnostic for back pain as pretty much everyone over 30 shows degraded discs etc, but most people are totally pain free. Unless you've done something really bad - which is highly unlikely.
I normally max out of Ibuprofen and co-codamol for a few days and if it doesn't calm down I go straight to a physio. My lower back is very adept at putting the muscles into spasm for no real reason.
dichlophenac. I never knew the side effects tbh I just thought it treated the local area ie back or knee pain but now I think about it it's obvious it's gets in your system.
That's off my list now thanks to doggy stomach issues.
Was on diclophenac for about 3yrs before my hip replacement.
Made me have chronic heart burn and horrible hangovers with massive stomach cramps.
Causes renal failure in vultures and is credited with a reduction in their numbers.
I take two Naproxen a day, along with Omeprazol. I had osteoarthritis diagnosed after an X-ray on my knee a while back, and I’m also prescribed Zapain.
Last October I had a real problem with my left arm, which stopped me sleeping, so I saw a doctor who gave me a month’s prescription for amitriptilyne, but the issue returned after I finished the course. A further phone consultation indicated I’ve got a carpal-tunnel issue, due to swelling and inflammation caused by arthritis after several years of working a paper folding machine. I’m managing the discomfort just with the two doses of naproxen along with a wrist brace at night, with the occasional dose of Zapain during the day. I’m on my feet all day, for twelve hours, I’m not at all sure I could spend any more time out of each day doing exercises that’s going to benefit both my knee and my wrist.
Drac, are you a medical professional, by any chance? After a week of barely sleeping when the inflammation in my wrist caused a sensation like hitting the ulnar nerve from my fingertips to my armpit, and meant I went nearly 48 hours with barely any sleep at all, I can now control it with two naproxen a day; I’ll go with the drugs, thank you. Despite what the song says, the drugs do work.
My job requires me to drive cars around the workplace, health and safety requirements dictate that the risk of falling asleep at the wheel is unacceptable.
Drac, are you a medical professional, by any chance?
I believe Drac is, or was, a paramedic though I may be mixing him up with someone else...
I'm fortunate to have private health coverage for physio thru my other halfs employer. I've had various lower back problems over the years including a couple of episode or bad spasms. Each time I've turned to a physio for help with the back rather than a GP....granted, a physio can't give you a prescription for some strong painkillers but neither can a GP "fix" your bad back.
Another option to consider is asking a pharmacist for avoid about drugs - after all, they are supposed to be the experts! (And I mean a proper Pharmacist not someone who just operates the cash register at Boots!)
Causes renal failure in vultures and is credited with a reduction in their numbers.
Lol, which GP prescribed diclophenac to vultures?!?!
As a long time 'bad back' sufferer, I can't recommend a chiropractor enough.
Mine will 'go' maybe once a year, but around 4 years ago went with a bang - lifting something and with the amount of moving and handling courses I've done, I should have known better.
It was to the point where I had to walk hunched over and that was a struggle doing 20yds.
Went to a chiropractor in St Albans and straight away, he felt my spine and located the cause of my lower back agony being caused 2/3 of the way up my spine. 6 weeks of weekly visits and I was right as rain
Been on Ketoprofen SR for the last 10 years or so, originally from a rhuematologit, now GP prescription. I have alkalysing spondylitis. It sorts me out, otherwise I can't sleep (bit better now but still plays up). Chiros just made the pain worse. It has kept me off the disease modifying drugs which can have some nasty side effects. I have an anual blood test for kidney problems from it but have been fine so far, touch wood.
Spinal manip isn't reccommended for alk spond
Bending to dry my feet out of the shower something painful occured and since then bending down and been a no-no. Fine first thing in the morning if I’m careful, gets progressively worse during the day.
This sounds very much like when my SI joint went out of position. It’s happened about 3 times over the years and is specifically down to poor or lack of stretching after exercise coupled with long periods sat down at work.
It’s a Very common injury that responds well to physio treatment. My physio charges £35 for a half hour session, which is usually enough to manipulate it back into place & show me correct stretches & exercises. The way I look at it is that this kind of money isn’t that much more than a few boxes of Ibuprofen.
Clearly yours could be something different but a private physio will usually perform an examination to try & diagnose the issue. I personally wouldn’t recommend using a Dr’s appointment for this - the GP is merely the gatekeeper to further NHS treatments; the physio has fixed mine every time.
Bending to dry my feet out of the shower something painful occured and since then bending down and been a no-no.
I've put my lower back out stretching in a gym! I have some weird neuro-muscular sensitivity which regularly gets set off and just locks up lower back. Movement is the best cure, but sometimes pain killers are needed to take the edge off. I've done it jumping off a trig point in the Lakes but oddly the fact I had to keep walking (it was mid route) meant it never had time to properly seize up.....