Many people with back or neck pain are prescribed oral pain medication, but research shows that 30% of people dislike or have trouble swallowing pills. These people may avoid taking medications because pills make them gag, or they feel like pills get stuck in their throats.

See Medications for Back Pain and Neck Pain

Most doctors underestimate the number of patients who have trouble swallowing medications, and it is often up to patients to raise the issue. Some patients can be helped with simple pill-swallowing techniques. Others, who have moderate to severe trouble swallowing pills, or who have trouble swallowing food as well as pills, may need to talk to their doctors about:

  • Potential pain medication alternatives
  • Identifying the underlying cause of their trouble swallowing and treating it

In addition:

  • People should never chew, break, or crush pills without consulting a physician or pharmacist

Chewing, breaking, or crushing pills changes the way a medication will be absorbed into the body and often affects the way a medication works. It can increase the chance of drug-related problems or side effects. For example, taking an altered oral opioid medication can cause breathing problems or an overdose if the medication is absorbed at too fast a rate. (Alternatively, if the altered medication becomes inactive, a person may experience withdrawal.)

See Opioid Medication Potential Risks and Complications

What is Dysphagia?

The medical term for physical difficulty swallowing or the sensation of difficulty swallowing is dysphagia. Sometimes dysphagia is accompanied by pain. The medical term for pain when swallowing is odynophagia.

Dysphagia has a number of potential underlying medical causes, including conditions affecting the spine, such as ankylosing spondylitis.

See Ankylosing Spondylitis


How Can Dysphagia Affect Back Pain?

When swallowing pills is challenging, a person may not take pain medications as often as prescribed. This can affect pain levels, overall health, and mood, as well ability to participate in physical therapy and exercise. In addition, leaving acute or postsurgical pain untreated allows the mind and body to create a well-worn pain pathway, which may increase the risk of developing chronic pain.

See Chronic Pain As a Disease: Why Does It Still Hurt?


How Can Dysphagia Affect Overall Health?

It is important to have dysphagia acknowledged and addressed, because trouble swallowing can put a person at risk for dehydration, malnutrition, and other problems, such as aspiration pneumonia.

Dr. Thomas Cohn is a physiatrist at the Center for Diagnostic Imaging in Minneapolis, MN. He specializes in interventional pain medicine and has more than 30 years of experience providing non-surgical spine care.