Brief Answer:
Noninflammatory and analgesic medicines

Detailed Answer:
Hello,

Thank you for using HCM to post your health query.
Back is not a typical place to have arthritis. The big joints are, like knees, hips, so joints that are used a lot during life.

But even if it was a muscular problem, or a joint problem, the treatment is the same.
-- Use noninflammatory and analgesic medications like Ibuprofen 600 mg 3 times/day, Naproxen 500mg 2 times/day or Voltaren 75mg twice/day. So by using one of them regularely, after food, for 4-6 weeks, will keep the pain and inflammation down and will help the healing.
-- Being active meanwhile is good, but not recommended overusing the joint or muscles. Tell your husband to avoid activities that cause him pain, and to do exercises that strengthen the other surrounding muscles. Contacting a physical therapist may be helpful, so they recommend the right exercises to do.

If worse or not better, I would recommend seeing a local doctor so he/she can do a physical examination and determine which is the exact problem.

Hope this is helpful.
Let me know if you need more clarifications.
Otherwise please close and rate the answer.

Regards,
Dr. Papaqako

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Brief Answer:
First choice is Ibuprofen, as the one with less side effects.

Detailed Answer:
Dear XXXXXXX

Thank you for the interesting follow-up question.

All these medications harm the kidneys, because they are eliminated through the kidney.
Though, diabetes is not a condition where the medications are contraindicated.
It is recommended to avoid them among high-risk patients (among patients with reduced estimated glomerular filtration rate (eGFR), volume depletion, heart failure, nephrotic syndrome, cirrhosis, and hypercalcemia. If your husband has any of these, then he should not use them.
Otherwise, Ibuprofen first, then if it is not helping Naproxen, then Voltaren should be your choice by level of side effects.

Mostly, I recommend my patients to start with Ibuprofen, the lowest dose of 400mg twice/day.
If it is not reliving completely the pain your husband can increase it to 400mg 3 times/day.
If he still has some pain, he can combine a analgesic/antiinflamatory cream and massage with it 3-4 times/day.
If stilll has some pain he can add paracetamol 400mg, 3 times/day. This combination should be enough.

Remember that if he decides to start Ibuprofen, he should stop aspirin and take it only as a blood thiner 80-100mg once/day and not more, because it is in the same family as the drugs mentioned above.

He should take them always with food, of after it, to protect his stomach.

Let me know if you have further questions.

Regards,

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