Common Medications Used After Vehicle-Related Accidents

Anti-inflammatories are a group of medications that shrink inflammation or swelling that occurs after injury to various tissues, such as muscles, ligaments, joints, nerves, etc. When an area becomes swollen or inflamed it stretches the surrounding tissues that usually contain nerve endings, thus causing pain. Thus, if you can decrease the swelling, you decrease the pressure on the nerves and thus decrease the pain. The safest anti-inflammatory is ice. It is very effective, inexpensive, and essentially has no side effects unless you are extremely sensitive to ice (which can occur in some conditions, such as fibromyalgia) or place the ice directly on your skin, which may cause an “ice burn”. To prevent this, place a thin paper towel or regular towel between the ice and the skin. It is almost impossible to ice an injured area too often. Placing ice on the area for ten minutes up to every hour while awake is extremely effective. I personally feel that heat should almost never be used after an injury, as this actually increases the blood flow to an area, thus causing more swelling and more pain. Over-the-counter anti-inflammatories include Aleve and Ibuprofen (commonly known as Advil). The usual adult dose of Aleve is to take 2 twice a day with meals, and Ibuprofen to take 3 two to three times a day with meals if you weight under 200 pounds and 4 if you weigh above 200 pounds. All anti-inflammatories can cause heartburn, indigestion, or acid regurgitation, and if any of these symptoms occur, they should be discontinued immediately. They should also not be taken if you are on any blood thinners, such as Plavix, Coumadin, etc., as a combination of these drugs increases the risk of bleeding of the stomach lining. There are also many prescription anti-inflammatories, and your physician may choose to prescribe one of these.

Muscle relaxers, as their name implies, relax muscles. Muscles commonly become tight or “spasm” because they may tear during the whiplash effect and bleed, which irritates the muscle and causes it to spasm, or they will spasm to protect or splint an underlying injured tissue. Muscle relaxers generally do not speed up your recovery, but certainly will decrease the amount of pain that you are in. Common muscle relaxers include Flexeril, Valium, Robaxin, Soma, and many others. They all can cause significant drowsiness and should never be used with alcohol, while driving, operating heavy machinery, or using sharp objects. We generally use them at night only to assist patients with sleeping.

Painkillers, like muscle relaxers, do not speed up your recovery but they block your brain’s ability to feel pain and thus increase your level of comfort. Commonly used painkillers are Hydrocodone (also known as Lortab or Vicodin) and Oxycodone (commonly known as Percocet). While there is certainly a valid reason to use these medications in the early stages of medical rehabilitation after an accident, they should be used with extreme caution because of their side effects and risk of dependency/addiction. In our office we limit their use to the first few months after an accident and, if pain management is still required, we refer our patients to a pain management specialist. All of the above medications have appropriate roles after a vehicle-related accident as long as they are used with appropriate caution.

A Better Way to Get Better,
Adrian Lewis
Adrian Lewis, MD