If you're dealing with chronic back pain, nerve pain, or joint pain, you've likely been offered medications as a primary solution. But the reality is—medications alone are rarely the best long-term answer.

At Horizon Spine & Pain of Utah, we take a modern, evidence-based approach to pain management that prioritizes treating the root cause of pain while minimizing long-term medication use.

Our Philosophy: Non-Medication First (When Possible)

We believe the best outcomes come from treating the underlying problem, not just masking symptoms.

That's why we prioritize:

Physical therapy for strength and stability
Chiropractic care for mobility and alignment
Targeted interventional procedures (epidural injections, nerve blocks, RFA)

These approaches often provide longer-lasting relief and improved function than medications alone.

Medications are used strategically—not as the default.

Understanding the Type of Pain Matters

Choosing the right medication starts with identifying the type of pain.

Inflammatory / Joint Pain

Arthritis, tendonitis, post-injury swelling
Responds best to NSAIDs

Neuropathic Pain (Nerve Pain)

Burning, tingling, shooting (sciatica, radiculopathy)
Treated with gabapentin, pregabalin, duloxetine

Mechanical Spine Pain

Disc herniation, spinal stenosis
Often requires injections and rehab, not just medication

Muscle-Spasm Pain

Tightness, cramping, acute flares
Responds to muscle relaxants

Acute and Postoperative Pain

Surgical recovery, acute injury
Often requires short-term multimodal therapy, sometimes including newer agents like Suzetrigine

Step 1: NSAIDs — Not All Are the Same

NSAIDs are often the first-line treatment, but choosing the right one matters.

Common NSAIDs:

Ibuprofen and Naproxen — good for short-term, over-the-counter use
Meloxicam and Celecoxib — longer-acting, once-daily options
Diclofenac — stronger anti-inflammatory effect

Why we choose one over another:

GI risk — Celecoxib may be safer
Convenience — Meloxicam (once daily)
Severity of inflammation — Diclofenac often stronger
Cardiovascular risk profile

The goal: maximize benefit while minimizing side effects.

Step 2: Non-Opioid Medications First

We prioritize non-opioid options whenever possible:

NSAIDs and acetaminophen
Topicals (lidocaine, diclofenac gel)
Neuropathic medications (gabapentin, pregabalin, duloxetine)

These are often highly effective when matched correctly to the pain type.

Step 3: Muscle Relaxers for Spasm-Driven Pain

Muscle spasms are a major contributor to back and neck pain, especially during acute flares.

Common options:

Methocarbamol
Cyclobenzaprine
Tizanidine

When we use them:

Acute low back pain flares
Post-procedural muscle tightening
Sleep-disrupting muscle spasms

Key considerations:

Best for short-term use
Can significantly improve mobility and comfort

Step 4: New Targeted Therapies (The Future of Pain Care)

One of the most exciting developments in pain medicine is Suzetrigine (Journavx).

How it works: Selectively blocks NaV1.8 sodium channels involved in pain signaling.

Why it matters:

Provides powerful pain relief without opioid risks
No respiratory depression
No addiction potential

Best uses:

Acute pain
Postoperative pain
Emerging role in chronic pain

This represents a shift toward precision, non-opioid pain control.

Step 5: Opioids — Used Carefully and Selectively

Opioids are not first-line therapy, but may be appropriate in select cases.

Options include:

Tramadol
Hydrocodone
Oxycodone
Buprenorphine

When we consider them:

Severe, function-limiting pain
Failure of other treatments
Short-term use or carefully monitored chronic use

Our approach:

Lowest effective dose
Shortest duration possible
Focus on function, not just pain scores

Buprenorphine is often preferred for chronic pain due to its improved safety profile.

Step 6: Combine Medications with Real Treatment

The best outcomes happen when medications are paired with:

Physical therapy
Movement optimization
Interventional procedures

This leads to:

Better pain control
Improved function
Reduced need for medications over time

Why Our Approach Works

At Horizon Spine & Pain of Utah, we:

Prioritize non-medication therapies first
Use medications strategically—not reflexively
Focus on long-term function and recovery
Offer advanced interventional options

When to See a Pain Specialist

You may benefit from evaluation if:

Pain lasts longer than 3 months
Medications aren't working
You want to avoid long-term opioids
Pain is limiting your life

Take the Next Step

If you're searching for pain management in Utah County, we're here to help you find a better path forward—one that doesn't rely solely on medications.

References

Centers for Disease Control and Prevention. 2022 Opioid Prescribing Guideline.
American College of Physicians. Low Back Pain Guidelines.
American Academy of Neurology. Neuropathic Pain Guidelines.
Finnerup NB et al. Lancet Neurology, 2015.
Dworkin RH et al. Pain, 2007.
Viscusi ER et al. NaV1.8 inhibitors and pain control.