Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-12-04T22:06:40.606Z Has data issue: false hasContentIssue false

Neck and back pain – radicular syndromes

from Chief complaints and diagnoses

Published online by Cambridge University Press:  18 December 2009

Stephen H. Thomas
Affiliation:
Harvard Medical School
Get access

Summary

The etiologic differences between radiating spine pain (RSP) and other causes of neck and back pain translate into differences in therapeutic approach. This chapter focuses on pharmacologic treatment modalities for RSP. Patients with refractory RSP often require opioid therapy, but available evidence does not support specific recommendations. Studies suggest no incremental benefit, compared with NSAIDs, for PO low-potency opioids (e.g. codeine) or agonist-antagonist agents (e.g. meptazinol, ethoheptazine). The authors believe that the main role for low-potency opioids in RSP is for use in patients who fail, or do not tolerate, other therapies such as NSAIDs. Corticosteroids have been used for the treatment of acute RSP since 1960s. The injection of corticosteroids into the epidural space is a commonly used approach. A single dose of methylprednisolone significantly reduces pain scores in RSP, but the effect is small in magnitude and limited in duration.
Type
Chapter
Information
Emergency Department Analgesia
An Evidence-Based Guide
, pp. 268 - 272
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×