Medication for Back Pain
Medicines can lower the intensity of your back pain and reduce muscle spasms. There are several different medication options your doctor may recommend.
Your doctor will determine which medication might help based on:
- How long you have been experiencing pain
- Additional symptoms you are experiencing, like muscle spasms
- Your medical history
It is important to be safe with pain medications and follow all your doctor’s instructions carefully.
The most common medications for treating back pain are:
- Acetaminophen and NSAIDs
- Topical pain relievers
- Muscle relaxers
- Opioids and narcotics
- Anti-seizure medicines
Acetaminophen and NSAIDs
Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are medications for treating pain you can get without a prescription. Your doctor may also prescribe them in stronger doses.
Acetaminophen inhibits the pain process, but how this works is unknown. Acetaminophen does not fight inflammation.
However, high doses of acetaminophen may cause liver damage. The FDA recommends no more than 4,000 mg of acetaminophen per day, but many doctors suggest taking closer to 3,000 mg.
Over-the-counter NSAIDs include ibuprofen, naproxen, and common aspirin. These can reduce pain and inflammation and are more potent than acetaminophen.
Common side effects of NSAIDs are stomach pain, nausea, constipation, and diarrhea. Long-term use of NSAIDs may cause very dangerous side effects, including:
- Gastrointestinal bleeding
- Heart problems
- Kidney damage
Topical Pain Relievers
Topical pain creams, gels, and lotions are applied to the skin and intended to relieve localized pain. You can get most of these without a prescription. Brands include Icy Hot and Ben Gay.
Common side effects may include redness, stinging or burning at the application site. You should stop using a topical pain reliever if you experience blisters, swelling, severe redness, increased or new pain.
Despite their name, muscle relaxers do not affect the muscles. They actually work in the spinal cord and brain.
Your doctor may prescribe a muscle relaxer along with an over-the-counter pain reliever for your back.
Side effects with muscle relaxers may include:
- Nausea and vomiting
Muscle relaxers can be habit forming so it is important to talk to your doctor before starting use.
Muscle relaxers may also interact with other medications you are taking or adversely affect other conditions you have. Lastly, you shouldn’t drink alcohol, drive or operate heavy machinery while taking muscle relaxers.
Opioids and Narcotics
It is possible that acetaminophen, NSAIDs, and muscle relaxers might not be enough to help alleviate your back pain. If your back pain is chronic and long lasting your doctor may suggest opioid or narcotic pain relievers.
These medications act on the pain receptors and nerve cells of the brain. Some opioids are milder and include Tylenol with codeine and Vicodin (acetaminophen and hydrocodone) while others are stronger and include morphine.
The most common side effects of opioid or narcotic pain relievers are:
- Drowsiness and/or a feeling of sedation
- Severe constipation
- Allergic reactions, including itching and hives
- Risk of addiction
Much like NSAIDs, corticosteroids help alleviate pain and bring down inflammation. Your doctor can prescribe corticosteroids in a pill form or via injections into your back.
Oral corticosteroids are generally prescribed in a tapering method over a short period of time.
They may also cause significant side effects, including:
- Elevated pressure in the eyes
- Fluid retention in the legs and swelling
- Elevated blood pressure
- Weight gain
- Problems with memory and mood
Injected corticosteroids may cause temporary side effects near the injection site. Other side effects include:
- Changes to skin color or texture
- Facial flushing
- High blood sugar
Your doctor will limit your injections to no more than four per year because of the high potential for side effects.
Corticosteroids may cause many side effects, including ones not listed, but they do help with inflammation and pain.
It is important to work with your doctor to find ways to minimize any of the above side effects.
Antidepressants seem to seem to work well for treating back pain but the pain relief mechanisms for these drugs are unknown. Researchers believe antidepressants increase pain reducing neurotransmitters in the spinal cord.
It may take a week or longer to get pain relief from an antidepressant. However, most people only experience moderate pain relief.
Side effects of these medications may include:
- Dry mouth
- Blurred vision
- Sleep problems
- Problems with urination
- Sexual problems
Anti-seizure medicines, including gabapentin, are used to treat seizures or epilepsy. They work by affecting the electric signals in the brain and are most effective in managing pain related to nerve damage.
These drugs may also help with long-term back pain and make it easier for you to work and manage daily activities.
Side effects of anti-seizure medications include:
- Weight gain or loss
- Upset stomach
- Loss of appetite
Do not stop taking anti-seizure medications suddenly or change the dose without first talking to your doctor.
Not every medication is going to work to treat your back pain. Talk to your doctor if a medicine doesn’t work for you.
It does take a trial and error approach to find a medication that does offer you pain relief.
As a final note, medication isn’t an effective to treatment alone for back pain. You should use it in conjunction with other treatments, including exercise, physical therapy, and heat and ice packs.