Painkillers: pills and shots frombackache, lower back pain

Update: December 2018

When there is severe pain in the back, lower back, joints,
Of course, first of all it is necessary to determine the cause of it.
occurrence. If it is a cross from hypothermia, lumbago, or
pinched sciatic nerve, intervertebral hernia, etc., should
be sure to be examined by a neurologist, an osteopath, and possibly
at the gynecologist, urologist, gastroenterologist, because back pain
can be not only from spasm of muscles and ligaments, but also with some
diseases of internal organs. After thorough diagnosis, the doctor
может назначить в composed комплексной терапии — НПATС, витамины
группы AT в уколах от боли в back.

What are the remedies that relieve back pain in


Today, in the treatment of acute pain in the lumbar region, back
medicine finds new principles and algorithms than 50 years ago.
The main focus in the fight against pain is to eliminate
боли с помощью НПATС — нестероидных противовоспалительных средств,
which both suppress inflammation and reduce pain, as well as carrying
muscle blockades.

And after removing severe spasms, it is recommended that
immobilizing the patient, i.e.
physical exercise, massage. Most doctors insist
on the fact that during pain in the back area a person is not
limited its activity as much as possible.

ATитамины группы AT

It has also become a popular and effective appointment of combined
vitamin complexes that can have moderate
обезболивающее действие, это витамины AT12, AT6, и AT1. It is believed that
более значительным анальгетическим свойством обладает витамин AT12.
Why these vitamins?

Recently, these drugs have been considered in
medicine as mild analgesics as they are
neurotropic – normalize the innervation of the muscles, are involved in
excitation transfer, in the metabolism of mediators, have an impact
on the metabolism, on the processes in the nervous system, contribute
repair damaged nerves.

Over 90 different studies have proven that use in
клинической практике витаминов группы AT, приводило к значительному
reduce pain in acute phases of inflammation in 
complex treatment. That’s whyх можно использовать как по
separately and in the form of complex preparations of vitamins of the group

AT composed большинства комплексных препаратов этой группы
contains lidocaine anesthetic that enhances the local
analgesic effect. However, remember that using
this group of vitamins makes sense only for acute back pain,
суставах, алкогольной полинейропатии, миастениях AT12 в течение
10-14 days, and for chronic recurrent diseases they already
become a little effective.


AT случаях, когда не помогают обезболивающие средства,
Specialists may suggest the patient a method of injection and stretching.
It consists in the following: after the patient lies on his stomach,
in the muscles find the most painful seals or points where the pain
the most intense, and make exactly perpendicular injection with a solution

Immediately after the injection, passive stretching of the muscle is produced,
after which a hot compress is placed on this place. Then when
the compress will be removed, the patient must produce active movements,
maximizing the movements of the painful muscle.

The goal of the Novocain blockade is to “turn off” the nerve. Therefore points
the injection should be as close as possible to the nerve exit points,
for example, the ischial – at the greater twist of the thigh, with intercostal
neuralgia – in the corresponding intercostal space, with
osteochondrosis – at the outer edge of the extensor back, etc. Also
It is advisable to carry out epidural blockade with chronic
pain syndrome, for example, with herniated intervertebral discs.

Below is a list of drugs prescribed by the attending physician.
according to indications. Only the doctor determines the appropriateness of
витаминов группы AT, НПATС, миорелаксантов, хондопротекторов.
The information below is intended for reference only.
and the dosage is determined by a specialist.

Когда болит спина or суставы уколы витаминов группы AT должны
to help

ATитамины группы AT можно принимать и в таблетированной форме, но
naturally, intramuscular administration is considered more effective.
drugs. Consider what drugs exist
this group in the modern pharmaceutical market, their common
indications, contraindications, side effects, methods of use
and comparative prices in pharmacies:


Milgamma 5 amp price in pharmacies 220 rubles, 10 amp. 400 rub. 25
amp 900 rub.

The composition of all these drugs is the same: Lidocaine, Thiamine,
Pyridoxine Cyanocobalamin.

Indications: It is used for neurological diseases and
syndromes of the nervous system in the complex therapy:

  • Neuritis, paresis of the facial nerve, trigeminal neuralgia
  • Back pains caused by diseases of the spine
    neurological manifestations (radiculopathy, lumboischialgia,
    muscular-tonic lumbar, cervical, neck-shoulder syndromes,
    intercostal neuralgia, radicular syndrome due to degenerative
    spinal changes)
  • night muscle cramps, alcoholic, diabetic
    polyneuropathy, herpes zoster.

Combilipen Combilipen

  • Combilipen 5 amp 100 -120 руб, 10 amp 170-210 rub.
  • Комплигамв 160 rub.

Противопоказания:  Нельзя проводить лечение при:

  • Pregnancy, lactation
  • acute, severe heart failure
  • hypersensitivity to the components of the combined vitamins
    группы AT
  • due to lack of research – children’s age

Neyrobion Neyrobion

3 amp 220 rub.- Neyrobion не содержит Лидокаин в своем

Side effects: Tachycardia, increased sweating, rarely –
allergic reactions – rash, itching, urticaria, skin reactions,
difficulty breathing, anaphylactic shock. In case of overdose –
nausea, vomiting, dizziness, tachycardia.

Trigamma Trigamma

5 amp около 100 rub.

Withменение: ATсе перечисленные уколы от боли в спине вводят
deep intramuscularly in a dose of 2 ml 1p / day for 5-10 days, in
Further, you should go to 2-3 p / week for 14-21 days. or
same as taking vitamins inside.

Эффективность, противопоказания и побочные действия НПATС

Pain relievers, of course, are only used as
symptomatic therapy, they help eliminate pain in
back, but do not eliminate the cause of its occurrence, besides
50% of patients may experience various side effects.

When conducting more than 50 studies aimed at identifying
лучшего обезболивающего средства, исследователи установor, что ни
один препарат из НПATС не отличился более высокой эффективностью,
than other painkillers, and in fact some of them are very
expensive drugs. The only thing to look for when
choice – some generics (Russian diclofenac, for example)
significantly inferior in effectiveness to original drugs
(европейский Diclofenac).

Also эти исследования были направлены на определение
drugs with the least side effects. AT
As a result, Ibuprofen was found to be the least
токсичным из всех НПATС.

Manufacturers of a new Cox-2 inhibitor, Celebrex, have stated that
it has the least side effects, but during
Research has not found conclusive evidence of this.

Therefore, when choosing a nonsteroidal anti-inflammatory agent
it should be remembered that they have almost the same
anesthetic property, the same side effects, but different
frequency, intensity, severity of side effects, harmful
impact, and not least – different prices. For example,
Meloxicam меньше влияет на желудок и кишечник, чем ацеклофенак
(Aertal). Indomethacin gives a pronounced analgesic effect, but
destroys cartilage during prolonged use and is now used
less and less.

Moreover, doubling the dose does not reduce the intensity of the pain, and in
If one non-steroid drug does not help (if it is not
fake), replacing it with another one doesn’t make sense. Moreover, on
Based on research, one can also conclude that they are not
much more effective than conventional paracetamol. Details about all ointments
back pain can be learned from our article.

ATыбор обезболивающих препаратов

For chronic pain before prescribing anesthetic
determines the causes and nature of chronic pain – reflected,
нейропатический or центральный, и назначает соответствующее


If the pain is acute, then the doctor determines the risk of side effects on
Gastrointestinal, cardiovascular complications, if the risks are not great, and:

  • диспепсии нет — то любое НПATС
  • диспепсия есть — лучше ибупрофен (or диклофенак, напроксен),
    нимесулид (or милоксикам)

If the risk of cardiovascular complications is high, then
избегать назначение НПATС, а использовать Парацетамол, опиоиды. With
moderate risk may be prescribed nimesulide, provided
adequate correction of blood pressure (amlodipine, see drugs to reduce

Если высок риск ЖКТ кровотечений — НПATС + обязательно ингибиторы
proton pump (omeprazole). Подразумевается, что прием НПATС – сам
alone is sufficient risk even with a single dose, therefore by
стандарту все НПATС принимаются в сочетаниях с блокаторами протонной
pump, regardless of the risk of gastroduodenal bleeding.

With сочетании рисков ЖКТ побочных действий и осложнений ССС —
Nimesulide + acetylsalicylic acid + omeprazole.

If the pain subsides within 5-7 days, then continue the treatment until
its complete cupping. If the acute pain does not subside during
weeks, then muscle relaxants, local anesthetics are prescribed. Local
the introduction of corticosteroids is possible with the exclusion of the diagnosis –
туберкулез суставов or позвоночника. With очень сильных болях и
no effect on painkillers should be excluded
the infectious nature of pain (tuberculosis pathology – consultation and
examination at a tuberculosis dispensary), joint pain
при гонорее, сифorсе or другой инфекции.

См. Как сделать укол внутримышечно самостоятельно и 
Ointment for pain in back.

Overview of painkillers injections

All known NSAIDs in injections, with their general contraindications and
side effects, average prices in pharmacies are presented in

Meloxicam Амелотекс

Мовалис (3 amp 530 rub.)
Амелотекс (3 amp- 280 rub.)
Артрозан (3 amp 190 rub)

Indications for use of NSAIDs: Symptomatic treatment
ankylosing spondylitis, osteoarthritis, rheumatoid arthritis,
elimination of pain – musculoskeletal, back pain of any etiology,
postoperative and other pain.

Ketoprofen Уколы от боли в спине

Артрозилен (6 amp 170 rub.)
Кетонал (10 amp 200 rub) Фламакс
(5 amp. 110 rubles). Флексен (6 amp 280 rub.)

Contraindications: Hypersensitivity to anyone.
component of the drug, heart failure, pregnancy and
lactation, severe liver or kidney failure,
bronchial asthma aspirin, children up to 16-18 years old,
inflammatory bowel disease, acute peptic ulcer disease
stomach, gastrointestinal bleeding. Cerebrovascular
заболевания,  ишемическая болезнь сердца, любые тяжелые
diseases of the cardiovascular system, joint reception
antiplatelet agents (clopidogrel, acetylsalicylic acid)
prednisone, abnormal liver function, severe somatic

With care: diseases of the digestive tract, the presence of Helicobacter infection
pylori, edema, fluid retention, diabetes, prolonged
the use of NSAIDs.

Ketorolac Кетанов

Кеторол (10 amp 130-150 rub.),
Кетанов (10 amp 100 rub.)
Ketorolac (10 амп 70-90 rub.)

Application: The solution for injections from back pain should be entered
deeply intramuscularly at a dosage adjusted by the doctor depending on
on the age of the patient, the intensity of the pain. Up to 65 years prescribed
single dose of 10-30 mg. IM every 4-6 hours. Persons with a violation
renal function or over 65 years old at a dose of 10-15 mg ip once, or
every 4-6 hours. The maximum daily dose should not be more than
60-90 mg. and the duration of therapy is not more than 5 days.

Diclofenac Diclofenac

Diclofenac (5 amp 40 rub)
ATольтарен (5 amp 270 rub.)
Наклофен (5 amp 50 rub.),
Ортофен (10 amp 40 rub.)

Побочные действия:  Пищеварительная система: часто —
diarrhea, gastralgia, constipation, vomiting, nausea, heartburn, hepatitis, acute
pancreatitis. Urinary system: frequent urination,
nephritis, edema, acute renal failure. Respiratory
system: shortness of breath, laryngeal edema, allergic rhinitis, difficulty
breathing. ЦНС: Наклофен головокружение, головная боль, сонливость,
hyperactivity, psychosis, hearing loss, depression, impairment
view. CAS: fainting, high blood pressure, edema
lungs. Organs of blood formation: eosinophilia, anemia, leukopenia.
Blood coagulation: rectal, epistaxis, gastric bleeding, from
postoperative wound. Dermatological manifestations: urticaria,
skin rash, peeling of the skin, Lyell’s syndrome, syndrome
Stevens Johnson. Allergic reactions: eyelid edema, wheezing
breathing, shortness of breath, discoloration of the skin, itchy skin, rash, heaviness
in the chest. Other: often – weight gain, edema
ankles, face, fingers, legs, excessive sweating.

Lornoxicam  Ксефокам

  • Ксефокам  (5 amp 700-720 rub.)
  • Tenoksikam
  • Тексамен 1 флак. 200 rub.

Overdose: vomiting, nausea, abdominal pain, onset
peptic ulcers of the stomach, metabolic acidosis, dysfunction
the kidneys.

ATзаимодействие:  Одновременное применение
NSAIDs with acetylsalicylic acid or other nonsteroidal
painkillers, as well as corticosteroids, calcium supplements,
ethanol, can cause gastrointestinal bleeding and
ulceration of the digestive tract. Simultaneous with paracetamol
increases the risk of nephrotoxicity.

Painkillers pills

When your back hurts, the doctor may prescribe
anti-inflammatory, painkillers in pills previously
it was believed that oral intake slows the onset of action,
reduces effectiveness and leads to stronger side effects
from the gastrointestinal tract. Today it is believed that intramuscular
administration and oral administration give equal bioavailability
drug. Side effects from the gastrointestinal tract are realized through
suppression of the arachidonic acid system, that is, not with direct
contact with mucous membranes, and after absorption into the blood. That’s why
side effects are almost the same when taken orally and when

Major NSAID tablets

  • Celebrex (active ingredient celecoxib 10 pcs. 400-420
  • Arcoxia (active ingredient Etoricoxib 7 pcs. 520-600
  • Texamen (active substance tenoxicam 10 pcs. 200-250
  • Nise, Nimulid, Nimika (active ingredient nimesulide price 20
    PC. 80-140 rub)
  • Налгезин (действующее вещество напрксен 10 PC. 110-130
  • Мовалис, Артрозан, Meloxicam (вещество Meloxicam цена 20
    tab. 40 руб, Мовалис 20 tab. 250 rub.)
  • Кетанов, Кетарол, Ketorolac (вещество Ketorolac цена 20 tab.
    40-60 rubles.)
  • Напроксен, Налгезин (вещество Напроксен, 120-260 rub)
  • Артрозилен, Быструмкапс, Кетонал, Флексен  (вещество
    кетопрофен 20 PC. 150 руб, Бысрумкапс 10 PC. 250-270 rub., Flexen
    30 PC. 170 rub.)
  • Burana, Nurofen, Faspik, Ibuprofen (substance Ibuprofen price 20
    PC. 15 руб, Нурофен 12 PC. 110 руб, Фаспик 6 PC. 100 rub, Burana 10
    PC. 80 rub.)
  • ATольтарен, Диклак, Наклофен, Ортофен, (вещество Diclofenac цена
    20 PC. 40 руб, ATольтарен 20 PC. 200 руб, Ортофен 30 PC. 20 rubles,
    Диклак 10 PC. 70-100 rubles.)
  • Аэртал 20 tab. 400 rub. – active substance
  • Ксефокам 10 PC.130-200 rub. – Lornoxicam.

Combined painkillers

  • Доларен, Паноксен (20 шт 120 rub) – диклофенак+
  • Нейродикловит (30 PC. 300 rub) – диклофенак+витамины группы
  • Некст (120-170 rub.) – парацетамол и ибупрофен.

Muscle relaxants

Most of the pain is based on muscle spasm, which itself
by itself pulls the nerve root and causes a secondary
radicular syndrome, therefore in many cases as
painkillers appointed muscle relaxants:

  • Толперизон –  периферического действия, Мидокалм
    (инструкция по применению, таблетки, инъекции 30 tab. по 50 и
    150мг 300-400 rub.), Толперизон 30 PC. 150-200 rub.
  • Hydroxysin – central with braking CNS, suitable for
    сильных болях, Атаракс 25 PC. 300 руб, Гидроксизин 25 PC. 200
  • Baclofen is also centrally active, Baklosan.
  • Тизанидин – центрального действия, Сирдалуд (2 мг 30 PC.230
    rub, 4 mg. 30 шт 330 rub), Тизанил (2 мг. 30 шт 170 rub, 4 mg. 30
    шт 250 rub), Тизалуд (2 мг. 30 PC. 140 rub), Тизанидин 4 мг. 30 PC.
    150-200 rub.


Chondroitin sulfate Хондрогард

Мукосат (5 amp 250-500 rub),
Хондрогард (10 amp 600 rub.),
Хондролон (10 amp 800-1100 rub),
Артрадол (10 amp 700 rub)

Chondroitin sulfate – этот препарат относится к
anti-inflammatory drugs, which is prescribed to treat
diseases of the joints and spine. It slows bone resorption.
tissue, improves calcium-phosphorus metabolism in cartilage tissues,
stops the destruction of connective and cartilage tissue, accelerates
recovery processes. Reduces soreness and
increases mobility of the spine and joints. Possesses
structural similarity with heparin, therefore, prevents the formation of
blood clots in the subchondral and synovial bed.

Alflutop Alflutop

Alflutop (10 amp 1400-1500 rub.)

This is a modern drug that is a concentrate of
small marine fish, regulating the metabolism of cartilage tissue. AT
The composition of the bioactive concentrate includes amino acids, potassium ions,
sodium, copper, iron, calcium and zinc, as well as mucopolysaccharides,
peptides. This tool stimulates the recovery of cartilage.
tissue, inhibits the destruction of the structures of bone and cartilage tissues than
provides a moderate analgesic effect.

The drug is prescribed only for adults with osteochondrosis or
polyosteoarthrosis, it should be administered in / m deep 1 ml / day course
20 days. If large joints are affected, an introduction is possible.
the drug inside the joint 1 time in 3-4 days 1-2 ml, course 5-6

ATидео как сделать укол внутримышечно.

ATидео как быстро снять боль в спине при помощи упражнений.

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