About one in four Americans has experienced low back pain within the past three months, making it one of the most common types of pain and the most frequent cause of disability in adults under 45.
Although pain medication can’t actually heal a back injury, it can relieve pain and open a window for other treatments -- such as physical therapy -- to have a chance to work.
There are multiple categories and types of medications for back pain; depending on how severe your symptoms are, how long you’ve had them, where they’re located, and what side effects you can tolerate.
The first medication of choice for most people with back pain is an over-the-counter, nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen (Motrin) or naproxen (Aleve), says Jae Jung, MD, assistant professor in the department of orthopaedics at the David Geffen School of Medicine at the University of California-Los Angeles. “These are considered milder analgesics, and would be the first tier of treatment,” he says.
Tylenol (acetaminophen), while not a nonsteroidal anti-inflammatory drug, is also a common over-the-counter pain reliever used to treat back pain.
There are also prescription-only NSAIDs, such as celecoxib (Celebrex), diclofenac (Voltaren), meloxicam (Mobic), and nabumetone (Relafen).
Although these medications are on the milder side of the pain relief spectrum, they still come with side effects -- especially if you take them at higher doses for a long time. NSAID side effects can include gastrointestinal problems, ulcers, and kidney damage, while acetaminophen can affect the liver.
Jung says he's had patients tell him they've been taking 6 to 8 ibuprofen daily for six months. “That can be a problem," he says. "In the pain world, anything more than three months is chronic pain. So, if you’ve been taking an NSAID or acetaminophen to manage back pain for three months or more, you should see a doctor to at least find out if you’re taking the right medication at the right dose.”
You can also get your anti-inflammatory medication in the form of a topical cream that can be applied directly to the back. While these technically have the potential for the same side effects as the oral medications, the risk is not the same, because they're not affecting your whole body, says Jung.
Other topical treatments that can be used for pain contain ingredients such as capsaicin, camphor, menthol, and eucalyptus oil.
If over-the-counter pain relievers or prescription NSAIDs are not relieving your back pain, your doctor may suggest adding a muscle relaxant. These medications include:
- Cyclobenzaprine (Flexeril)
- Tizanidine (Zanaflex)
- Baclofen (Lioresal)
- Carisoprodol (Soma)
There are many brand names in the same category, says Jung. They help relieve the muscle spasms that are causing your back pain.