Gentle Back and Neck Care

05/26/2026

Medications That Can Cause Pain
By Gregory Cofano, DC, DICBN(c)

Forty million people in the U.S. suffer from some form of peripheral neuropathy.1 The causes of peripheral neuropathy stem from systemic diseases such as diabetes mellitus, autoimmune disorders, side effects from medications, toxic exposures, infections, and hereditary diseases.2-3 Each different condition can also result in damage specifically to sensory, motor or autonomic nerve fibers, or a combination of these nerve fibers.3

Let's discuss several classes of medications that can cause peripheral neuropathy. The prevalence of peripheral neuropathy increases as patients age; in fact, 8 percent of patients 55 years and older have been diagnosed with neuropathic pain.4 If you have been told you have peripheral neuropathy and your physician has ruled out systemic diseases, toxic exposures, infections and hereditary disorders, then consider the medications you're taking as a potential cause.
Statins

Many Americans take statins, lipid-lowering agents such as lovastatin and simvastatin. Published research is now identifying that hyperlipidemia is the single largest contributing factor to developing neuropathy, largely because most of those patients are put on statins.5-6

It has been determined that patients on long-term statin medication may substantially increase their risk of developing polyneuropathy.7 Statins have been found to primarily cause sensory neuropathy, which means patients taking these medications can have loss of sensation, loss of balance and pain.2

Antidysrhythmics

Antidysrhythmics are another class of medications many older adults are taking. These medicines are used to suppress abnormal rhythms of the heart. Digoxin, amiodarone, phenytoin or dilantin, and procainamide have all been identified to cause peripheral neuropathy.2

These cardiac medications have been found to cause sensory neuropathy only or sensorimotor neuropathy with axonal-damage neuropathies, meaning patients taking these medications can experience loss of sensation, loss of balance, pain and weakness.2

Antibiotics

Certain antibiotics are the next class of medications that have the potential to cause peripheral neuropathy. Nitrofurantoin (Macrobid) is an antibiotic used to treat and prevent urinary tract infections, and this medication can cause sensorimotor neuropathy.2

Fluoroquinolones are broad-spectrum antibiotics commonly prescribed to treat respiratory and urinary infections. Common brands names of fluoroquinolones include Cipro, Levaquin, Avelox, Noroxin and Floxin. Many of the newer fluoroquinolones have been found to be linked to serious nerve damage, and the FDA is strengthening its warnings regarding these medications.8

Mainstream medical treatment for neuropathy has two overall goals. The first is to control underlying disease processes, such as managing systemic diseases like diabetes, hypothyroidism, vitamin deficiencies, renal disease and chronic liver disease; and identifying and eliminating toxins such as alcohol and treating infections that can lead to neuropathy.

The second goal is to control symptoms with medications including gabapentin or neurontin, Lyrica and antidepressants. These medications all affect the central nervous system and cause drowsiness, fatigue, dizziness and difficulty walking.

It is clear that the medications discussed above can lead to neuropathy, and the medications used to treat neuropathic pain can be unpleasant for patients to be on long term. Being cognizant of medication side effects and asking your doctor to do a drug interaction check greatly improves the odds that you will avoid a problem (whether you have neuropathy or not). Your doctor should always check for drug interactions between your medications and supplements as well.

References

Hovaguimian A, Gibbons CH. Diagnosis and treatment of pain in small-fiber neuropathy. Curr Pain Headache Rep, 2011 Jun;15(3):193-200.
Azhary H, Farooq MU, Bhanushali M, et al. Peripheral neuropathy: differential diagnosis and management. Am Fam Physician, 2010 Apr 1;81(7):887-92.
Levine T. Small fiber neuropathy: disease classification beyond pain and burning. J Cent Nerv Syst Dis, 2018 Apr 18;10: 1179573518771703.
Martyn CN, Hughes RA. Epidemiology of peripheral neuropathy. J Neurol Neurosurg Psychiatry, 1997 Apr;62(4):310-8.
Vincent AM, Hinder LM, Pop-Busui R, et al. Hyperlipidemia: a new therapeutic target for diabetic neuropathy. J Peripher Nerv Syst, 2009 Dec;14(4):257-67.
Wiggin TD, Sullivan KA, Pop-Busui R, et al. Elevated triglycerides correlate with progression of diabetic neuropathy. Diabetes, 2009 Jul;58(7):1634-40.
Gaist D, Jeppesen U, Andersen M, et al. Statins and risk of polyneuropathy: a case-control study. Neurology, 2002 May 14;58(9):1333-7.
Cofano G, Hennings M, Sergent A. Vertigo secondary to fluoroquinolone neuropathy: a case report. Ann Vertebral Sublux Res, 2016 May;(9):29-31.
Gregory Cofano, DC, DICBN(c),is a board-eligible chiropractic neurologist and former assistant professor at Palmer College of Chiropractic. He has authored several journal publications concerning neurotoxic medications causing neuropathy and other neurological conditions of the central and peripheral nervous system. Currently, Dr. Cofano practices conservative neuropathy treatment in Seattle, Wash.

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05/18/2026

May 🌸
Womens Health Month
Remember to focus on your physical & mental health

Have a wonderful Memorial Day!
🇺🇸
Let us remember those who gave the ultimate sacrifice serving this country 🙏

05/18/2026

May 🌸
Womens Health Month
Remember to focus on your physical & mental health

Have a wonderful Memorial Day!
🇺🇸
Let us remember those who gave the ultimate sacrifice serving this country 🙏

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05/11/2026

Half~off coupon ($80) on your 1st two chiropractic visits with Dr Lena! When you mention Memorial Day Special by May 31.

05/04/2026

Why Chiropractic Is Your Best Option for Pain
By Editorial Staff

Pain is a major problem, but so is medication used to help relieve the pain. If you haven't realized by now that chiropractic care, not drugs, is your best option for pain, perhaps you'll be swayed by some recent research. Let's take a quick look at two studies in particular. Follow along and see how the latest research supports our conclusion. It's not too late to avoid the pain-reliever epidemic. It's never too late to choose chiropractic.

First, a study published in the Journal of the American Medical Association suggests nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Aleve), Motrin and other commonly administered pain relievers, are more effective than opioids for relieving chronic back, knee and hip pain. NSAIDs also win out over opioids in terms of reducing limitations in the ability to perform activities of daily living (walking, working, sleeping, etc.). So, point #1: Opioids aren't your best option for pain.

But neither are NSAIDs, at least when compared to chiropractic, according to a study that also appeared in the Journal of the American Medical Association. Chiropractic spinal manipulation reduced pain and improved function in back pain patients after six weeks of treatment, and results were similar to that achieved with NSAID use – *but without the side effects and other risks associated with medication use (particularly use for more than 10 days at a time). So, point #2: NSAIDs aren't your best option, either.

Point #3 should be clear by now: When it comes to pain relief, chiropractic care is the effective, safe option to turn to first – a point emphasized by an increasing number of major health care organizations these days. Talk to your doctor about the risks associated with opioids and other pain relievers, and why chiropractic care is the natural, drug-free first choice. Make the right choice ... choose chiropractic today.

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04/22/2026

Happy Earth Day 🌎🌼What can we do to help preserve earth for the next generation?

04/14/2026

FDA Cracks Down on Epidural Corticosteroids

By Editorial Staff

Just after publishing Dr. Deborah Pate's review of epidural corticosteroid injections for sciatica (April 22 newsletter – "Steroids for Sciatica: More Trouble Than They're Worth), which concluded, based on the available evidence, that epidural steroid injections "have little clinical benefit (short or long term), and are associated with significant risks ...

cause deterioration of bone quality, elevating the risk of spinal fracture ... and have increased dramatically [in terms of use] despite lack of evidence to justify the procedure," the Food & Drug Administration has issued a warning regarding their use that specifies even more severe potential consequences. According to the FDA in its April 23, 2014 announcement:
"Injection of corticosteroids into the epidural space of the spine may result in rare but serious adverse events, including loss of vision, stroke, paralysis, and death. The injections are given to treat neck and back pain, and radiating pain in the arms and legs. The effectiveness and safety of epidural administration of corticosteroids have not been established, and FDA has not approved corticosteroids for this use."

The FDA is requiring that drug labels of injectable corticosteroids carry a warning detailing these potential risks, and recommends that patients "discuss the benefits and risks of epidural corticosteroid injections with their health care professionals, along with the benefits and risks associated with other possible treatments."

The administration also announced plans to convene a meeting of "external experts" later this year to discuss the benefits vs. risks of epidural corticosteroid injections. The advisory committee meeting could lead to further FDA actions.

In the meantime, talk to your doctor of chiropractic about if you're experiencing back pain, neck pain or any other condition commonly addressed by a DC with conservative, drug-free care.

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04/11/2026

Chiropractic for Sciatica ⚡️

By Editorial Staff

Radicular low back pain, or pain that radiates from the low back down the back of the leg, is known as sciatica. Too often, medical doctors prescribe gabapentin, an anti-convulsant / anti-epileptic medication used as an off-label treatment for sciatica.

Chiropractic spinal adjustment is your best option for treating sciatica, since the usual cause is a pinched / inflamed spinal nerve. New research also shows that patients with sciatica improve under chiropractic care to the point that they are less likely to need gabapentin, underscoring chiropractic's effectiveness.
Researchers found that among adults under age 50 with newly diagnosed radicular low back pain, patients who received chiropractic spinal manipulative therapy were significantly less likely to be prescribed gabapentin over a one-year follow-up period. Compared to patients who did not receive chiropractic SMT (and who received standard medical care instead, including medication), patients who visited a chiropractor were 53 percent less likely to need gabapentin in the following year. Findings appear in BMJ Open.

Not surprisingly, gabapentin's off-label use is not supported by research, according to the study authors, who state that "systematic reviews in 2018 and 2022 demonstrated clear evidence of lack of its effectiveness for [radicular low back pain]. Additionally, there is growing evidence of its risks including abuse, misuse, dependence and withdrawal. … Several clinical practice guidelines do not recommend gabapentin for the treatment of LBP or rLBP, including those of the American Family Physician (2017). Evidence supporting the use of gabapentin for LBP is considered inconclusive by guidelines from the North American Spine Society (2020), Global Spine Care Initiative (2020) and Veterans Affairs/Department of Defense (2019 and 2022)."

By the way, previous research also suggests chiropractic spinal manipulative therapy reduces the odds of needing a prescription for opioids or benzodiazepines (neither of which are recommended for acute low back pain or radicular LBP, either, according to the study authors.)

Not the first time a medication has been prescribed – either for an intended or off-label use – despite the potential for more harm than good. But that leads us to the clear takeaway for anyone with sciatica, particularly if their medical doctor has recommended or prescribed gabapentin (or another medication):
Go to a chiropractor instead!

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04/05/2026