Medicine can decrease low back pain and reduce muscle spasms in some people. But medicine alone is not an effective treatment for low back pain. It should be used along with other treatments, such as exercise and physical therapy.

Medication Choices

Medicine for acute low back pain²

Nonsteroidal anti-inflammatory drugs (NSAIDs) that reduce pain, swelling, and irritation are the most likely to be effective for acute low back pain.

Other medicines are used, but research has not proven them to be helpful. These include:

• Painkillers (acetaminophen, opiates).
• Epidural corticosteroid injections.

Muscle relaxants are also used sometimes, but they can have significant side effects, such as drowsiness. Some people develop a dependence on the medicine. For some people, the benefit from muscle relaxants is not worth the risk of side effects or dependence.

Medicine for chronic low back pain⁴

There are no medicines that have been proven to reliably decrease chronic back pain, but several medicines are likely to help. These include:

• Painkillers (opiates alone or combined with acetaminophen).
• Antidepressants (such as tricyclics). Antidepressants help ease back pain in people who also have depression, and may be helpful even for people who do not have depression.¹⁷
• Nonsteroidal anti-inflammatory drugs (NSAIDs).
• Muscle relaxants, which help with pain but also have side effects such as making you feel dizzy or sleepy.

Anesthetic or corticosteroid injections have all been prescribed for chronic low back pain, but they have not been researched enough to know whether they are effective for most people.

You may also hear of people having facet joint injections of anesthetic or corticosteroid for low back pain, but research has shown this to be ineffective or even harmful.

What To Think About

When making treatment decisions, bear in mind that medicines that work for some people don't work for others. Let your doctor know if the medicine you are taking is not effective. There may be another option to help control your back pain.

Anticonvulsants are sometimes used to treat low back pain, even though there isn't strong evidence that they help.

Botulinum toxin A (Botox) injection into the back muscles for chronic low back pain is an experimental treatment.