ICU Decoded › Library › OPD › Bones & joints › Neck & back painNeck & back pain
Bones & joints · OPD · Locked · first month free
By Dr Javed Akhtar · Last reviewed 2 October 2026
Drugs on this card
Aceclofenac, Etoricoxib, Diclofenac gel, Paracetamol (little effect alone in back pain), Thiocolchicoside (spasm), Duloxetine (chronic)
Advice and when to refer Stay active: Heat, walking and exercise; no bed rest; most settle in 2–6 wk (NICE NG59 2026; ACP 2017, latest)Red flags — MRI urgently: Leg weakness, numb saddle area, bladder or bowel change, fever, weight loss, cancer history, night pain, TB contact (NICE NG59 2026)Investigations
First visit No imaging for non-specific pain — Most acute back or neck pain settles in 6 weeks.Only if indicated MRI spine urgently — Red flags: leg weakness, saddle numbness, bladder or bowel change, cancer history, fever, weight loss, night pain.CBC, ESR/CRP — Fever, weight loss or inflammatory pattern.X-ray spine — Trauma or suspected fracture in the elderly; TB spine (gibbus).HLA-B27 and sacroiliac MRI — Inflammatory back pain under 45 (ankylosing spondylitis).
Locked The adult dose for each drug Indian brand names for each drug, with a link to buy Open Neck & back pain in OPD
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