How Aspirin Can Work for Back Pain

Aspirin and a glass of water
Aspirin and a glass of water. Stephen Swintek/Stone/Getty Images

Aspirin for Back Pain

The use of aspirin (acetylsalicylic acid) in some form is nearly as old as civilization itself.

Hippocrates, and even the ancient Egyptians used an early form of it (salicin, from the white willow tree) to treat pain and fever. Aspirin as a medicine to treat pain was developed by the Bayer company in the 1800s. More recently, aspirin has become a therapy for preventing cardiovascular disease and stroke, but using it in this way should be done according to your doctor's recommendations.

Drug Class and Category of Aspirin

Categorized as an analgesic, aspirin is an over-the-counter non-steroidal anti-inflammatory medication, or NSAID. NSAIDs are used to relieve pain and inflammation. In some of these types of drugs, aspirin is the sole ingredient, while in others, it is combined with other(s).

How Aspirin Works

Aspirin treats pain, fever, and inflammation. It can be used for muscle pain, arthritis, minor injuries, and other conditions. Aspirin is available in tablet and capsule form,  as gum or as a suppository.  The tablets may be plain aspirin, enteric-coated, extended release, buffered or chew-able.

If you take an extended release or enteric-coated tablets, take them whole - do not crush or chew.

Like other NSAIDs, aspirin works by preventing chemicals (called prostaglandins) from being formed. The body makes a variety of prostaglandins - each with a different function.

What's the purpose of a prostaglandin?

 The short answer is it varies.  Some bring about inflammation. Others relay pain signals, help blood clots to form, or maintain the health of the lining of the stomach. As aspirin blocks the creation of these prostaglandins, it may  contribute to, among other things, prevention of pain and/or inflammation.

When you take aspirin, it is distributed all around the body; this means along with pain relief, it may exert its effects in unintended places, as well.

Side Effects

Side effects associated with aspirin are generally rare, but they can occur.  After you swallow an aspirin, its active ingredient is released in your stomach.

Recall that prostaglandins play a role in blood clotting as well as maintaining the stomach lining. As aspirin inhibits the formation of prostaglandins, it may lead to bleeding in the GI (gastrointestinal tract. Side effects in the GI tract can also include irritation or ulcers. If you have a peptic ulcer, aspirin may cause a recurrence.

Some people try to minimize or avoid GI-related side effects by taking an enteric-coated form of the drug.  The thinking is that enteric-coated aspirin waits until it reaches the small intestine before it dissolves.  (This is because the pH in the small intestine is more alkaline than it is in the stomach.)

The problem is, this strategy doesn't lower the risk of GI tract problems related to taking aspirin.

 In fact, it may even be harmful. The Berkeley Wellness newsletter says enteric coated aspirin is designed to minimize stomach discomfort, which is a different issue than reducing the risk of GI tract bleeding.  Plus, some prostaglandins (and thromboxanes, another substance that aspirin blocks) are beneficial to your stomach. But aspirin is an equal opportunity blocker, meaning these useful chemicals will also be pr. ed from forming. The Berkeley Wellness explains that the systemic effect of taking aspirin - regardless of where in the body the aspirin dissolves - is what often leads to stomach bleeding.

Other Aspirin Side Effects and Complications

Aspirin allergy also may occur in some individuals, which would take the form of hives, facial swelling, wheezing and/or shock. People with GI tract, liver or kidney problems, allergy to aspirin or other NSAIDS, should check with their doctor before taking aspirin. Aspirin sometimes causes ringing in the ears and/or partial deafness. If hearing problems occur after you take aspirin, call your doctor immediately.

Alcohol and aspirin are not a good mix. Taking alcohol with aspirin can increase the risk of stomach bleeding or otherwise affect how the drug works in your body. Ask your doctor or read the label carefully to find out the maximum number of drinks you can have between doses.

Aspirin and Children - a Special Warning

Aspirin and kids don't always mix.

Aspirin is known to cause a rare disease in minors called Reye's Syndrome, which has devastating and even lethal outcomes. If you do give aspirin to your child, monitor them carefully to be sure they are not taking more than the recommended dose. Overdosing is particularly dangerous in children.

One effective way to do this is to keep the aspirin bottle out of their reach. Another is to never give a child an adult version of aspirin.

Symptoms in children that require immediate medical attention include changes in behavior, drowsiness, and/or fast or deep breathing.

 

Source:

Berkeley Wellness. Is Enteric-Coated Aspirin Safer? Berkeley Wellness Newsletter. April 2013. http://www.berkeleywellness.com/self-care/over-counter-products/article/enteric-coated-aspirin-safer

Cryer, B., Mahaffey, K. J Multidiscip Healthc. Gastrointestinal ulcers, role of aspirin, and clinical outcomes: pathobiology, diagnosis, and treatment March 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3970722/

Other Health Problems and Aspirin

If you are breastfeeding, pregnant (or are trying to get pregnant), have stomach problems, lupus, asthma, heart failure, high blood pressure or kidney disease, vitamin K deficiency, nasal polyps, anemia, bleeding or clotting problems or you are a smoker, consult your doctor before trying aspirin.

Other Medications and Aspirin

It is a good idea to consult with your doctor before adding aspirin your current medication mix, as number of substances may interact with it.

Interactions may occur not only with medications, such as other NSAIDs, but also with some herbal supplements or recreational drugs. If you take medication for diabetes, gout or seizure, or you take hormones, antacids, blood thinning medication, or other aspirin products, or if you are unsure about combining aspirin with what you currently take it's best to speak with your doctor about taking aspirin.

Storing Your Aspirin

Many people store medications, including aspirin, in their bathroom medicine chest, or in the kitchen, near the faucet. But to keep your aspirin in good working order, it is best to store it away from heat and moisture. If it smells like vinegar, it has likely begun to disintegrate and should be discarded.

Dosage

Take aspirin according to the instructions on the box. Don't take more pills than indicated or dose more frequently. Drink a full glass of water with the dose. If you take aspirin routinely, and you miss a dose, take it as soon as you can, unless it is almost time for the next dose.

If you have health problems, or are taking other medications, check with your doctor for the dosage information that is right for you.

Brands

Aspirin is readily available in generic form. There are also quite a few brands of aspirin. Common brand names for aspirin include (but are not limited to) Bayer, Ascriptin, Ecotrin, Empirin, ZORprin and others.

 

Sources:

Is Enteric-Coated Aspirin Safer? Berkeley Wellness. April 2013.

Brenner, GM, Stevens, CW, Pharmacology. 2nd ed. Saunders Elsevier. 2006. Philadelphia.

Hochadel, M., PhD., ed., The AARP Guide to Pills., Gold Standard Publishers. Tampa, Fl 2006.

Perez-Pena,. Secrets of the Mummy. New York Times. Sept 2005.

How Aspirin Works. The Neurology Reading Room. The Johns Hopkins Hospital website. Dec 2002.

Raffa, R., Rawls, S., Beyzarov, E. Netter's Illustrated Pharmacology. Icon Learning Systems. Teterborough, NJ. 2005

Salicylates (Systemic). Drugs.com website. Nov 2007.

Stringer, J. Basic Concepts in Pharmacology. 3rd ed. McGraw Hill. 2006.

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