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Opiate Pain Relievers for Spinal Stenosis

Examples

Generic Name Brand Name
hydrocodone Norco, Vicodin
hydromorphone Dilaudid, Exalgo
morphine Astramorph, Avinza
oxycodone OxyContin, Percocet
tramadol Ryzolt, Ultram

Opiates are also called opioids or narcotics.

Opiates are sometimes combined with other medicines. For example, Percocet is oxycodone combined with acetaminophen.

How It Works

Opiates are prescription narcotic medicines that are similar to pain-relieving substances naturally produced by the body (endorphins). Opiates suppress your perception of pain by reducing the number of pain signals sent by the nervous system and calm your emotional response to pain by reducing the brain's reaction to pain signals.

Why It Is Used

Opiates are sometimes used to relieve flare-ups of low back pain caused by pressure on the spinal nerve roots due to lumbar spinal stenosis. Stenosis can squeeze and irritate the nerve roots, causing moderate to severe pain. Opiates can be a responsible way to treat pain if the pain is not relieved by other treatments and you cannot do daily activities. They are usually used only for short periods of time, which helps you avoid side effects.

How Well It Works

Opioids are effective in reducing osteoarthritis pain that has not been relieved by other medicines. Osteoarthritis is a common cause of spinal stenosis. Opioids do not relieve inflammation, so they are often combined with an anti-inflammatory medicine (NSAIDs).1

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.
  • Signs of an overdose, including:
    • Cold, clammy skin.
    • Confusion.
    • Severe nervousness or restlessness.
    • Severe dizziness, drowsiness, or weakness.
    • Slow breathing.
    • Seizures.

Call your doctor if you have:

  • Hives.
  • A fast, slow, or pounding heartbeat.
  • Increased sweating.
  • Redness or flushing of the face.

Common side effects of this medicine include:

  • Constipation.
  • Dizziness, lightheadedness, or feeling faint.
  • Drowsiness.
  • Nausea or vomiting.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Opiate pain relievers are strong medicines that can be very helpful in treating pain, especially after an injury or surgery. They are safest when you use them exactly as your doctor prescribes. But there is a risk of addiction when you take them for more than a few days. The risk is lower if you follow your doctor's instructions on how to take them. Your risk is slightly higher if you or someone in your family has a history of substance abuse. If you are worried about addiction, talk with your doctor.

Some of these medicines have acetaminophen in them. Check the labels on all the other nonprescription and prescription medicines you take. Many medicines have acetaminophen. Do not take two or more medicines with acetaminophen in them unless your doctor has told you to. Taking too much acetaminophen can be harmful. If you have questions about this, talk to your doctor or pharmacist.

Opiates may be considered if other medicines and treatments have not controlled your pain or are not safe for you. To make this decision, you and your doctor may consider:

Dry mouth is common with these medicines. To help with dry mouth, you can chew sugarless gum, suck on sugarless candy, or melt ice in your mouth. If you continue to have problems with dry mouth after a couple of weeks, call your doctor. Dry mouth can lead to tooth decay and gum disease.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Lozada CJ (2013). Treatment of osteoarthritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology 9th ed., vol. 2, pp. 1646–1659. Philadelphia: Saunders.

Credits

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer Robert B. Keller, MD - Orthopedics
Current as of June 4, 2014

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