Does pepto bismol help with gerd. Pepto-Bismol vs Tums: Which Antacid Is More Effective for GERD and Heartburn Relief

02.04.202316.07.2023 by alexxlab

What are the key differences between Pepto-Bismol and Tums. How do these popular antacids work to relieve heartburn symptoms. Which medication is more effective for treating GERD and acid reflux. What are the potential side effects and drug interactions to be aware of.

Содержание

Understanding Pepto-Bismol and Tums: Composition and Mechanism of Action

Pepto-Bismol and Tums are two of the most commonly used over-the-counter medications for treating heartburn and indigestion. While both provide relief from stomach acid-related discomfort, they work in slightly different ways due to their unique compositions.

What is Pepto-Bismol made of?

Pepto-Bismol’s active ingredient is bismuth subsalicylate. This compound combines the antimicrobial effects of bismuth with the anti-inflammatory and antisecretory properties of salicylate. As a result, Pepto-Bismol can:

Neutralize stomach acid
Reduce inflammation in the stomach and intestinal lining
Fight certain bacteria that cause diarrhea
Decrease fluid and electrolyte loss in the digestive tract

What is Tums composed of?

Tums contains calcium carbonate as its primary active ingredient. This potent antacid works by directly neutralizing stomach acid through a chemical reaction. When calcium carbonate interacts with stomach acid, it produces:

Calcium chloride
Carbon dioxide
Water

The production of carbon dioxide can lead to belching and flatulence, which are common side effects of Tums.

Comparing the Effectiveness of Pepto-Bismol and Tums for Various Digestive Issues

While both medications can provide relief from heartburn and indigestion, their effectiveness may vary depending on the specific condition being treated.

How effective is Pepto-Bismol for heartburn and GERD?

Pepto-Bismol is FDA-approved for treating heartburn, which can be a symptom of acid reflux and gastroesophageal reflux disease (GERD). Its multi-faceted approach to digestive issues makes it effective for:

Acid indigestion
Abdominal discomfort
Bloating
Nausea
Traveler’s diarrhea
Occasional diarrhea
Peptic ulcer disease caused by Helicobacter pylori (when combined with antibiotics)

How well does Tums work for acid reflux and indigestion?

Tums is primarily used to treat heartburn and indigestion. Its rapid acid-neutralizing effect can provide quick relief from:

Heartburn
Acid reflux symptoms
Bloating
Abdominal discomfort

Some versions of Tums also contain simethicone, which can help alleviate gas and flatulence associated with indigestion.

Onset of Action and Duration: Pepto-Bismol vs Tums

The speed at which these medications take effect and how long their relief lasts can be important factors in choosing between them.

How quickly does Pepto-Bismol work?

Pepto-Bismol typically begins to work within 30-60 minutes of ingestion. Its effects can last for several hours, providing extended relief from digestive discomfort.

What is the onset of action for Tums?

Tums starts working almost immediately upon ingestion, as the calcium carbonate begins neutralizing stomach acid right away. However, its effects may not last as long as those of Pepto-Bismol or other antacids like H2 blockers.

Side Effects and Safety Considerations for Pepto-Bismol and Tums

While both medications are generally considered safe for occasional use, they can cause side effects and may not be suitable for everyone.

What are the common side effects of Pepto-Bismol?

Pepto-Bismol may cause:

Temporary darkening of the tongue and stool
Constipation
Nausea
Ringing in the ears (rare)

Are there any side effects associated with Tums use?

Tums side effects may include:

Belching
Gas
Constipation (with excessive use)
Hypercalcemia (rare, with long-term overuse)

Drug Interactions and Precautions: What to Know Before Taking Pepto-Bismol or Tums

Both medications can interact with other drugs and may not be suitable for certain medical conditions.

What medications interact with Pepto-Bismol?

Pepto-Bismol may interact with:

Blood thinners (e.g., warfarin)
Tetracycline antibiotics
Medications for gout (e.g., probenecid)
Diabetes medications

Are there any drug interactions with Tums?

Tums can interact with:

Thyroid medications
Certain antibiotics (e.g., tetracyclines, fluoroquinolones)
Iron supplements
Some HIV medications

It’s crucial to consult with a healthcare provider before using either medication, especially if you’re taking other drugs or have underlying health conditions.

Cost Comparison and Availability: Pepto-Bismol vs Tums

Both medications are widely available over the counter, but their costs can vary.

How much does Pepto-Bismol typically cost?

Pepto-Bismol is generally more expensive than Tums, with prices ranging from $5 to $15 for a bottle of liquid or a pack of tablets, depending on the size and formulation.

What is the average price of Tums?

Tums is usually less expensive, with prices ranging from $3 to $10 for a bottle of tablets, depending on the quantity and strength.

Both medications are rarely covered by insurance plans or Medicare, as they are available over the counter. However, some flexible spending accounts (FSAs) or health savings accounts (HSAs) may cover these purchases.

Choosing Between Pepto-Bismol and Tums: Factors to Consider

When deciding which medication to use for digestive issues, several factors should be taken into account:

What symptoms are you experiencing?

If you’re primarily dealing with heartburn and indigestion, both medications can be effective. However, if you’re also experiencing diarrhea or nausea, Pepto-Bismol may be more suitable due to its broader range of effects.

How quickly do you need relief?

Tums provides faster initial relief, while Pepto-Bismol’s effects may last longer. Consider the timing and duration of your symptoms when choosing between the two.

Do you have any underlying health conditions?

Certain medical conditions may make one medication more appropriate than the other. For example, people with a history of bleeding disorders should avoid Pepto-Bismol due to its salicylate content.

Are you taking any other medications?

Check for potential drug interactions with any other medications you’re currently taking before choosing an antacid.

What form of medication do you prefer?

Pepto-Bismol is available in liquid, tablet, and chewable forms, while Tums primarily comes as chewable tablets. Consider which form is easiest for you to take.

In conclusion, both Pepto-Bismol and Tums can be effective for treating heartburn and indigestion, but they have different strengths and potential side effects. For occasional use, either medication can provide relief from digestive discomfort. However, if you’re experiencing frequent or severe symptoms, it’s important to consult with a healthcare provider to determine the underlying cause and the most appropriate treatment plan.

Remember that while these over-the-counter medications can provide temporary relief, they are not intended for long-term use without medical supervision. Persistent symptoms of GERD or frequent heartburn may require prescription medications or lifestyle changes for effective management. Always follow the dosage instructions on the package and seek medical advice if your symptoms persist or worsen.

Differences, similarities, and which is better for you

Whether you’ve experienced mild indigestion or occasional heartburn, you’ve probably come across Pepto-Bismol and Tums at some point. These drugs are two of the most common over-the-counter (OTC) medicines for heartburn.

Both Pepto-Bismol and Tums have antacid effects, which help neutralize stomach acid. Too much stomach acid after eating spicy foods or large meals can sometimes cause a burning sensation or discomfort in the chest and upper abdominal region. Antacids can help relieve these symptoms.

What are the main differences between Pepto-Bismol and Tums?

Pepto-Bismol is the brand name for bismuth subsalicylate. Bismuth has antimicrobial effects against certain diarrhea-causing bacteria while subsalicylate has antisecretory effects against fluid and electrolyte loss. Bismuth subsalicylate also has anti-inflammatory actions on the stomach and intestinal lining. For these reasons, Pepto-Bismol can be used as an antacid or antidiarrheal agent.

Pepto-Bismol is notably found as an oral liquid. However, it also comes in regular tablets and chewable tablets. It’s important to note that, while most forms of Pepto-Bismol contain bismuth subsalicylate, Children’s Pepto-Bismol often contains calcium carbonate.

Tums is a brand name for calcium carbonate. It’s considered a potent antacid that directly neutralizes stomach acid. Calcium carbonate reacts with stomach acid to form calcium chloride, carbon dioxide, and water. Because of excess carbon dioxide production in the stomach, belching and gas (flatulence) are common side effects of Tums.

Unlike Pepto-Bismol, Tums is mainly found as a chewable tablet in regular-strength and extra-strength forms. Tums is typically used by those older than 12 years old, but children’s versions of Tums are also available. Some versions of Children’s Tums contains simethicone to help relieve gas.

RELATED: Pepto-Bismol details | Children’s Pepto-Bismol details | Tums details

Want the best price on Pepto-Bismol?

Get price alerts

Conditions treated by Pepto-Bismol and Tums

Pepto-Bismol is FDA approved to treat heartburn, a digestive problem that can also be a symptom of acid reflux and GERD (gastroesophageal reflux disease). Pepto-Bismol can treat acid indigestion, which includes symptoms like abdominal discomfort, bloating, and nausea. In addition, Pepto-Bismol can treat traveler’s diarrhea and occasional diarrhea, as well as peptic ulcer disease caused by Helicobacter pylori. When used for H. pylori, bismuth subsalicylate is taken with other antibiotics to treat the infection.

Tums is labeled to treat heartburn and indigestion. It helps neutralize and decrease the amount of acid in the stomach to relieve symptoms such as bloating and abdominal discomfort. Calcium carbonate is sometimes combined with simethicone to relieve symptoms of gas and flatulence associated with indigestion.

Because Pepto-Bismol can sometimes contain calcium carbonate—the same ingredient in Tums—it’s important to check the package labeling and ask your healthcare provider to make sure you’re taking the right product.

Is Pepto-Bismol or Tums more effective?

Currently, there are no comprehensive reviews directly comparing Pepto-Bismol and Tums. Studies have shown that bismuth subsalicylate and calcium carbonate are commonly used to treat indigestion because of their acid-reducing effects.

Compared with h3 blockers like Pepcid (famotidine) and Zantac (ranitidine), Tums works faster and relieves symptoms for a shorter period of time. Compared with other antacids like Alka-Seltzer (sodium bicarbonate) and Maalox (aluminum hydroxide/magnesium hydroxide), Tums has a slightly slower onset of action, but its effects may last longer.

Pepto-Bismol is more effective for other uses such as treating diarrhea and H. pylori infections. Bismuth subsalicylate has been shown to help heal peptic ulcers while fighting bacteria, especially when combined with antibiotics like metronidazole and clarithromycin.

Consult a healthcare provider for the best treatment option for occasional heartburn and indigestion. More serious cases of heartburn, such as acid reflux disease or GERD, may require other medications like proton pump inhibitors (PPIs). Drugs labeled as PPIs include Prevacid (lansoprazole) and Prilosec (omeprazole).

RELATED: Alka-Seltzer details

Want the best price on Tums?

Get price alerts

Coverage and cost comparison of Pepto-Bismol vs. Tums

Medicare and insurance plans rarely cover over-the-counter (OTC) medications like Pepto-Bismol and Tums. In cases where a prescription version of an OTC drug is available, insurance plans may decide to cover it.

Get the SingleCare coupon card

The average costs of Pepto-Bismol and Tums vary depending on which pharmacy you go to. However, these drugs are relatively inexpensive. Still, you may be able to save more with a SingleCare Pepto-Bismol coupon or SingleCare Tums coupon if prescribed by a doctor.

Common side effects of Pepto-Bismol vs. Tums

Pepto-Bismol can often cause a darkened color of the stool or tongue. This is because bismuth subsalicylate can react with small amounts of sulfur to create bismuth sulfide, a black substance. While darkened stool may be confused with bloody stool (a serious condition), this side effect is temporary and harmless. Some people also report mild constipation after taking Pepto-Bismol.

Side effects of Tums include belching and gas (flatulence). Tums may also cause constipation and dry mouth.

Rare but serious effects of Pepto-Bismol may include tinnitus or a constant ringing in the ear that could indicate hearing problems. Other serious side effects of Tums include symptoms of high calcium levels (hypercalcemia), such as weakness, bone pain, and fatigue.

^*not reported

This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.

Source: NIH (Pepto-Bismol), NIH (Tums)

Drug interactions of Pepto-Bismol vs. Tums

Pepto-Bismol can interact with many of the same medications that aspirin interacts with. Bismuth subsalicylate can interact with warfarin and increase the risk of bleeding. When taken with anti-gout agents like probenecid, bismuth subsalicylate can decrease anti-gout effects. Pepto-Bismol can also decrease the absorption and effectiveness of tetracycline and quinolone antibiotics.

Tums can decrease the effects of tetracycline and quinolone antibiotics. Calcium cations can also bind with antifungals, like itraconazole, and decrease their absorption and effectiveness. Certain antibiotics, antifungal agents, and iron supplements should be avoided at least two hours before or after taking calcium carbonate.

Consult a healthcare professional for other possible drug interactions.

Warnings of Pepto-Bismol and Tums

Those who are sensitive to aspirin products should avoid taking Pepto-Bismol and other salicylate drugs. Otherwise, hypersensitivity reactions, such as rashes, are a potential adverse effect.

Pepto-Bismol should be avoided in children younger than 12 years old. Children who are recovering from chickenpox or influenza are at an increased risk of Reye’s syndrome after taking bismuth subsalicylate. In very rare cases, Pepto-Bismol can lead to neurotoxicity, especially in those with AIDS. Signs and symptoms of neurotoxicity may include tremors, confusion, or seizures.

Since Tums contains calcium carbonate, it should be avoided or monitored with other calcium-containing products. In severe cases, too much calcium can damage the kidneys, weaken bones, and affect the functions of the brain and heart.

Consult your healthcare provider for other precautions to be aware of while taking Pepto-Bismol or Tums.

Frequently asked questions about Pepto-Bismol vs.

Tums

What is Pepto-Bismol?

Pepto-Bismol is an over-the-counter drug that contains bismuth subsalicylate. It’s used to treat mild, infrequent heartburn, indigestion, and diarrhea. Bismuth subsalicylate is also approved to treat H. pylori infections when used along with other antibiotics. Pepto-Bismol is available in an oral suspension, oral tablet, and oral chewable tablet.

What is Tums?

Tums is the brand for calcium carbonate. It is used to treat occasional heartburn and indigestion. Tums is available in regular-strength and extra-strength chewable tablets.

Are Pepto-Bismol and Tums the same?

Pepto-Bismol and Tums are not the same. They contain different active ingredients and come in different formulations. However, some versions of Pepto-Bismol may contain calcium carbonate, the same active ingredient in Tums. Check the label of the drug before purchasing to make sure it contains the ingredients you’re looking for.

Is Pepto-Bismol or Tums better?

Pepto-Bismol and Tums are both effective drugs for treating occasional symptoms of heartburn or indigestion. They both work relatively quickly and work for a short duration. One may be preferred over the other depending on sugar contents and inactive ingredients, as well as whether it comes in a liquid or chewable tablet. Cost may also play a role in determining the best option.

Can I use Pepto-Bismol or Tums while pregnant?

Pepto-Bismol is not generally recommended for pregnant women due to a possible increased risk of bleeding. Tums may be taken occasionally for indigestion in recommended doses. However, it’s important for pregnant women to be aware of calcium intake since they may be taking other prenatal vitamins or supplements. Get medical advice from your healthcare provider if you’re experiencing heartburn or indigestion while pregnant.

Can I use Pepto-Bismol or Tums with alcohol?

Alcohol should be avoided while taking Pepto-Bismol or Tums. Alcohol may irritate the lining of the stomach or intestines and alter the overall effectiveness of antacids and antidiarrheal agents.

Is Tums good for an upset stomach?

Tums is an affordable, effective option for treating an upset stomach. Chewable Tums tablets start working within five minutes and can be taken as needed. Tums should only be used for mild, occasional heartburn and indigestion. If you’re needing to use Tums consistently for more than 14 days, consult a healthcare provider.

Is Pepto Bismol an antacid?

Pepto-Bismol has mild antacid effects to help relieve symptoms of heartburn and indigestion. It also works as an antidiarrheal agent that is commonly used to treat traveler’s diarrhea. Pepto-Bismol works by coating the lining of the digestive tract while preventing fluid and electrolyte loss.

Uses, types, side effects, and safety

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission Here’s our process.

Medical News Today only shows you brands and products that we stand behind.

Our team thoroughly researches and evaluates the recommendations we make on our site. To establish that the product manufacturers addressed safety and efficacy standards, we:

Evaluate ingredients and composition: Do they have the potential to cause harm?
Fact-check all health claims: Do they align with the current body of scientific evidence?
Assess the brand: Does it operate with integrity and adhere to industry best practices?

We do the research so you can find trusted products for your health and wellness.

list of prohibited and undesirable things

One of the most uncomfortable complications of osteochondrosis – intervertebral hernia – dangerously severe penetrating pain, stiffness of movements, and in the absence of treatment – even more significant disruption of the body. A disease caused by trauma or age-related changes in the body is no less dangerous.

In this article:

Toggle

Knowing what can not be done with a hernia of the spine, it is possible to alleviate periods of exacerbation of the disease, increase the effectiveness of treatment, and speed up the rehabilitation period.

A herniated disc causes severe pain.

Features of intervertebral hernia

The most common modifications of the vertebrae are sequestrated and dorsal hernia. In the first case, the contents of the disk move into the lumen of the spinal canal, which is accompanied by severe neck pain.

With dorsal protrusion, the disc, due to deformation, begins to put pressure on the spinal canal and provokes pinching of the nerve endings.

This pathology is accompanied by pain in the lumbar region, which in later stages begins to radiate to the legs (or arms in case of a hernia in the neck). To clarify the tactics of treating disc herniation, a clinical examination and MRI of the spine are performed, where the hernia itself is visible and the causes of pain become clear.

The impact of the disease on daily life

Herniated discs cause degeneration of the discs and also tend to grow. As it increases, pain intensifies, excessive swelling is observed, inflammatory processes are activated and spread faster.

As a result, the patient is unable to perform daily activities, forced to suspend professional activities. The disease can be bedridden for hours, and sometimes days. If a herniated disc is not treated, the disease can lead to disability.

What not to do with intervertebral hernia

Diagnosis of vertebral hernia is a reason to pay close attention to lifestyle, nutrition, psychological and emotional state.

Care should be taken when playing sports – any sudden movements can cause an exacerbation of the disease, accompanied by severe pain, and sometimes a partial loss of motor ability, numbness.

Ignore dangerous symptoms

Spinal herniation has symptoms that, if ignored, can make the situation worse. The worst case scenario is injury to the spinal cord with damaged cartilage and, as a result, paralysis.

Lumbar hernia has a negative impact on the functioning of the intestines and pelvic organs, causes weakening of the muscles, and cervical hernia is dangerous because it can provoke an ischemic stroke.

To prevent deterioration, the treatment of the disease must begin immediately after diagnosis.

Symptoms that may indicate the presence of a herniated disc:

intermittent pain in the lumbosacral, cervical or thoracic spine that increases with exertion;
tingling, numbness of the lower extremities and sometimes of the fingers;
radiating pains: in the shoulder, arm, back of the lower leg and thigh, buttock;
persistent chest pain;
migraine, high blood pressure, dizziness, as well as the simultaneous manifestation of all three factors;
disruption of the pelvic organs: discomfort, problems with urination or defecation (incontinence, diarrhea, constipation, etc. ), erectile dysfunction;
decreased activity, weakness, especially in the lower extremities;
sleep disorders;
development of scoliosis;
fainting.

Sleep disturbances are a possible symptom of the development of spinal hernia.

Lifting weights without observing the correct technique

Any physical activity in the presence of a spinal hernia in a patient requires preparation: warming up and developing muscles.

Do not lift heavy bags, move household items, do athletics, in particular:

perform leg presses and bench presses;
lift barbells and other sports equipment;
do weighted bends.

Make sharp amplitude movements of the body

It will not be possible to perform sharp movements during the acute phase of the disease, but it is important not to forget about your own safety even during the period of relief.

It is impossible to take off sharply, especially with heavy bags in your hands, it is not recommended to run, so as not to provoke a decrease in the depreciation properties of the spine, aggravation of pathology and various complications.

What other abrupt movements are better not to do:

twisting;
any deep intensive movements.

In case of a herniated disc, it is not recommended to play football, basketball, volleyball, ride a bicycle, keep the load on straight legs – this is fraught with muscle hypertonicity and an increase in pain in the area of the disease focus.

Along with sudden movements, with intervertebral hernia, inactivity, frequent stay in a static position are unfavorable – for example, when driving a car or performing the same type of surgical work.

In this case, the intervertebral disc ceases to receive the required amount of vitamins, minerals, building materials, which reduces its elasticity and aggravates the current condition.

However, with such a pathology, physical activity, warm-ups and gymnastics are important and necessary. Therapeutic complexes of exercises for herniated vertebrae can only be selected by an experienced specialist.

Wearing rigid corsets

Doctors do not recommend wearing a rigid corset in case of protrusion of the intervertebral disc. The product can relieve the condition for a while, but with regular wear it will help to weaken the muscles, which, in the event of a recurrence of the disease, will lead to increased pain.

It is not recommended to wear rigid corsets all the time.

Gaining weight

Gaining weight can cause an accelerated development of the disease, so it is necessary to follow a diet in case of a herniated disc.

Doctors recommend to exclude from the diet:

dishes with a lot of salt and sugar;
pastries;
fast food;
white rice;
non-natural desserts;
ice cream;
canned food;
smoked products;
alcohol;
carbonated and caffeinated drinks.

To be in constant stress

Chronic stress in combination with impaired functioning of the immune system and a decrease in the body’s barrier functions can cause an increased development of spinal hernia.

In order not to cause the progression of the disease, it is necessary to identify the causes of stress and eliminate them.

When you are constantly under tension or in a state of nervous breakdown, the fascia and muscles contract and put pressure on the disc, which causes pain.

In this case, the blood flow in the tissues is disturbed, the muscles lose elasticity, and the lumen narrows in the vessels, which can lead to the development of concomitant diseases and complications.

Hypothermia

Hypothermia, getting wet causes spasm of the muscles of the body, accompanied by malaise and weakness. When a hernia of the spine is prohibited, bathing in ice water, rubbing with snow, dousing with cold water and other methods of hardening.

Overheating can also provoke deterioration. Visiting steam rooms in baths and saunas is highly discouraged. Overheating of the body is fraught with swelling and accelerated development of the inflammatory process.

With a hernia of the spine, one should not overcool and overheat.

Do spinal traction in the acute period of the disease

Orthopedic traction of the injured area is an effective method of treatment in many areas, for example in traumatology for fractured bones to reduce displaced fragments.

As for diseases of the spine, especially complicated by herniated discs, this method is very effective. With it, you can try to set the hernia. But it must be borne in mind that traction can provoke attacks of acute pain if it is carried out in the acute period of the disease and in the presence of a pronounced inflammatory process.

Walking in high heels

Doctors advise women to give up high-heeled shoes in favor of comfortable shoes. Additionally, you need to monitor your posture and try not to hunch your back.

Self-treatment without medical advice

The lack of competent therapy, inaction in relation to the disease, as well as the abuse of traditional methods of treatment can lead to sad consequences.

Alternative and traditional medicine can only temporarily relieve symptoms and supplement the main treatment prescribed by a specialist.

Remember, the longer the delay period, the more difficult it is to fight the disease and the negative changes that it provoked.

Spinal herniation is a dangerous pathology that can lead to immobilization of limbs and life in a wheelchair. At this stage, the consequences of the disease are irreversible.

It is important to start timely treatment – this will avoid surgical intervention, which is fraught with complications and difficult rehabilitation.

It is necessary to consult with physicians before using any alternative methods of treatment.

Why you should not immediately solve back problems with surgery

If the course of the disease is characterized only by pain and has not yet had time to cause other disturbances in the body, then it is advisable to use more gentle treatment methods compared to surgery for the treatment of intervertebral hernia.

Massage and manual therapy, as well as other methods patented by Soviet and modern scientists, are highly effective in this direction.

Clinic “Meddiagnostics” in Kyiv conducts comprehensive hardware diagnostics of patients with suspected protrusion of the intervertebral discs, has 42 years of experience in this area of medicine.

Detailed examinations allow you to accurately determine the size of the hernia, its features and promptly prescribe effective non-surgical treatment – all in one place.

Will the condition improve if the prohibitions are followed?

Nevertheless, it is not recommended to ignore pain in the lumbosacral, thoracic or cervical region of the back and engage in self-medication, since the effectiveness of therapy for protrusion of the intervertebral discs directly depends on the stage of the disease.

Gongalsky Vladimir Vladimirovich

Doctor of Medical Sciences in the specialty “Neurology”, the highest category in the specialty “traumatology-orthopedics”

Make an appointment
How to get there

Hernia has nothing to do with it: how to get rid of back pain that lasts for more than a year

According to WHO, almost a billion people worldwide suffer from back pain – and these are just the cases included in official statistics. The prevalence of back pain and its impact on people’s quality of life and performance is driving scientists around the world to investigate this condition. A huge amount of data has been accumulated, but it does not always reach its application in medical practice. For example, one of the most likely diagnoses that a patient with back pain in Russia can receive is “osteochondrosis”.

“Osteochondrosis is a purely radiological diagnosis, the conclusion of a radiologist, which is understood as natural age-related changes in the vertebrae. Their presence can almost never explain the patient’s symptoms. Studies were conducted: they took, for example, a thousand patients with back pain and a thousand healthy people. At the same time, both of them often had approximately the same degenerative changes in the vertebrae according to X-ray and MRI data, ”neurologist Nikolai Votchitsev explained to Gazeta.Ru.

Many patients are convinced that their pain is associated not only with osteochondrosis, but also with intervertebral hernia. One of the most common mistakes due to this belief is going to an MRI without a doctor’s appointment out of a desire to save money on a second appointment.

“Osteochondrosis, protrusions and hernias rarely cause back pain – different studies give an estimate of one to ten percent. Basically, back pain is associated with problems in the tissues surrounding the spine.

Sometimes back pain can be caused by causes that are not related to the musculoskeletal system. For example, kidney diseases can “give” to the back, ”Vyacheslav Ushakov, a doctor in physical and rehabilitation medicine, told Gazeta.Ru.

According to Votchitsev, MRI is only a tool that allows you to test the doctor’s clinical hypothesis. However, in some cases, snapshots are indispensable. If there are red flags: the pain is acute and does not go away after taking an anesthetic, there is weakness in the legs, numbness in the perineum, some kind of malfunction of the pelvic organs, the doctor will definitely send for an MRI, Ushakov explained. At the same time, it is important to go to the hospital as soon as possible.

“If you don’t have these red flags, you can try to manage your back pain on your own. But here it all depends on the condition of the patient. Mild pain that you are already familiar with is usually not dangerous. It may go away on its own within a few days or weeks. Pain due to an intervertebral hernia is difficult to confuse with something, so the patient is unlikely to wait so long, ”Ushakov explained.

“Herniated discs most often hurt not in the back, but in the extremities. Such pain may be accompanied by shootings, similar to a current discharge, tingling sensations, goosebumps, muscle twisting. Sometimes there is muscle weakness. Quite often, when treating hernias, conservative treatment is enough: from painkillers, anti-inflammatory and muscle relaxants to hormones and anticonvulsants.
The last type of drugs works for neuropathic pain, which is caused by hernias, ”said Votchitsev.

There are many ways to deal with myofascial syndrome. At the same time, there is no universal recipe, and often a combination of methods is needed. But the most effective means is physical activity. The main thing is that the exercises are chosen by a competent specialist, otherwise they can harm even more. This applies not only to classes on land, but also in the pool.

“Patients often find swimming the cure for all back problems, especially scoliosis. Firstly, swimming does not protect against scoliosis and can worsen it if practiced without a competent coach. Secondly, scoliosis and pain do not have a direct relationship. If a person’s scoliosis is less than 50 degrees, the pain will almost never be directly related to the curvature of the spine. In addition, even at the fourth stage of scoliosis, there may be no pain, ”said Votchitsev.

A physical therapist can help you choose the right exercises. As Votchitsev explained, doctors in this specialty select ergonomics, recommend exercises to a person, tell how to live after an injury or illness in order to return to a full life – in general, they do things that go beyond an hourly appointment with a neurologist or orthopedist.

“Advice to patients: do not confuse physiotherapy with physical therapy. Physiotherapy – all sorts of electrophoresis, darsonval, magnetotherapy – in most cases have no effect. Of the hardware methods, shock wave therapy, high-intensity laser and high-intensity magnet have limited proven effectiveness. All these procedures are prescribed by the doctor individually, ”Votchitsev explained.

Sometimes people with back pain or herniated discs avoid physical activity for fear of hurting themselves. But there is not much evidence for this.

“If a person has an acute condition and neuropathic pain is observed, it is really worth saving yourself by limiting physical activity. Another thing is if some kind of domestic incident occurred, for example, “a muscle was pulled”, and the doctor ruled out a serious illness. If we are talking about a simple myofascial pain syndrome, you need to anesthetize the patient with drugs, kinesio taping or something else, and this is always done by a doctor. Residual pain after that does not harm health in any way. Statistically, 80% of these residual pains will go away on their own within two weeks.
Hernias that do not cause symptoms, which were accidentally found on MRI, in most cases are also not a contraindication to physical activity, but there are exceptions, ”Votchitsev explained.

Kinesiology taping can be added to training. According to Votchitsev, performed by a competent doctor, it can help with myofascial syndrome, although its effectiveness has not yet been fully confirmed by studies. Before training or for relaxation, you can use myofascial release (self-massage on a roll).

“But I highly recommend asking a professional to show you the technique before using it yourself,” Votchitsev warned.

Experts agreed that dry needle therapy, which differs from traditional acupuncture, has limited efficacy. This method has developed in Western medical practice and is based not on the impact on certain active points or the balance of energies in the body, but on the direct impact of a needle on a spasmodic muscle in order to relax. In certain cases, this may work, but you should not rely on it. Massage can work the same way.

“From the point of view of evidence-based medicine, massage is purely a procedure for pleasure. But sometimes it can work wonders. No matter how strange it may sound, massage can affect the central nervous system, that is, the mechanical effect of the massage therapist’s hands on muscle tissue is secondary.
Simplifying, the massage therapist can “explain” to the nervous system, the brain that the spasm is no longer needed, that the muscle can be relaxed. This takes the pain away. However, if a person does not change their lifestyle, do not begin to exercise regularly and meaningfully and do not reduce stress levels, the pain may return immediately after the end of the massage course, ”said Votchitsev.

With back pain, people turn to different specialists: neurologists, vertebrologists, chiropractors, osteopaths, kinesiologists. Rehabilitologist Ushakov warns patients: “Any doctor who has undertaken to treat you should review your MRI scans. A person who has not seen them has no right to manipulate your back. Maybe your pain is due to a hernia, maybe something else. Of course, pain due to direct problems with the spine is statistically rare, but still the spinal column is a complex structure, you cannot work blindly with it. Better to be safe for your health.”

“Osteopaths are a separate issue. If you do not consider self-taught with certificates after dubious courses, then osteopathy is an official medical discipline that includes craniosacral therapy, manipulation of internal organs and direct work with joints and muscles. The first is a dubious discipline, since the laying on of hands is supposed to correct the bones of the skull, regulate the flow of cerebrospinal fluid and treat almost everything in the world with this. The same osteopaths who specialize in the latter technique are quite normal physical therapists with knowledge of the matter and an adequate approach to solving problems of the musculoskeletal system. As for the biomechanical approach, it is important to understand which specialist you trust with your health. For example, the widely advertised applied kinesiology can give a wow effect, but as a rule, it is short-term, which requires you to return to the specialist again and again,” Votchitsev warned.

If you have already tried all the physical methods, but the pain remains, do not despair. Perhaps antidepressants will help. This does not mean that you will have to turn to a psychiatrist, since a neurologist can also prescribe antidepressants, Votchitsev emphasized.

“Chronic pain, and any, not just back pain, causes a restructuring of the central nervous system at the cellular and biochemical level. At the same time, patients often develop a depressive state. They describe their pain as debilitating, get used to it, sleep poorly, and are often regulars at doctors. These patients often benefit from antidepressants. Not only depressed, but also anxious patients are also often prone to back pain.