Opioid Pain Medications
Narcotic (or opioid) pain medicines such as codeine, oxycodone, hydrocodone, and morphine work by blocking the transmission of pain messages to the brain. Narcotic drugs should only be used under a doctor’s supervision because they can cause physical dependence and addiction. Other side effects include severe drowsiness and constipation.
Muscle relaxants such as diazepam ( Valium) or cyclobenzaprine ( Amrix, Fexmid, Flexeril) act on the central nervous system to relieve painful muscle strains and spasms. However, these drugs can be habit-forming. Muscle relaxants also can cause side effects, including sedation and dizziness.
Some drugs typically prescribed to treat depression have also been shown to help relieve chronic lower back pain, and doctors sometimes prescribe these medications to alleviate pain. Duloxetine ( Cymbalta) is approved for chronic musculoskeletal pain including pain from osteoarthritis and chronic low back pain. Low doses of tricyclic antidepressants such as amitriptyline ( Elavil, Endep, Vanatrip) and desipramine ( Norpramin) are often used to treat low back pain. Side effects of these drugs may include drowsiness, dizziness, dry mouth, and appetite loss.
Antiepileptic drugs such as Fanatrex, Gabarone, Gralise, Horizant, Neurontin ( gabapentin) or Lyrica ( pregabalin) were designed to help people with seizure disorders and are often used for the treatment of painful syndromes caused by the virus that causes shingles. They also may be effective for chronic low back pain. They appear to work by interfering with pain signals from the nerves. Potential side effects include drowsiness, dizziness, and sedation. These drugs work for some people but not others, and one anticonvulsant drug may work for you while other drugs may not.
If oral medications aren't enough to relieve your lower back pain, your doctor may inject a steroid medication into the space around your spinal cord to bring down inflammation and provide short-term pain relief. And scientific studies show mixed results about whether they are effective at relieving back pain.
Other options are injections of a numbing medicine (anesthetic) to block pain or botulinum toxin A ( Botox) – the same treatment used to reduce the appearance of wrinkles. Botox injections work by paralyzing muscles to stop spasms. Although it is not FDA-approved for back pain, some doctors may prescribe Botox to relieve low back pain caused by muscle tension. It may take three to 10 days to start feeling better after a Botox injection, but the effects may last for three to four months. Side effects may include muscle paralysis and difficulty swallowing.