Which Medicines Help With Low Back Pain?

If you’ve ever had low back pain, you may have scanned the shelves of your local drugstore or filled a prescription from your doctor. But not all medicines are created equal. Here are some of the most common ones for low back pain.

Acetaminophen (Tylenol)

Your doctor may suggest this as a first-line treatment. It works by stopping the pain process. But it doesn’t reduce inflammation in the body.

Acetaminophen tends to be gentler on the stomach than other meds. But while it can be helpful in relieving toothaches, headaches, and pain after surgery, there’s not a lot of evidence to indicate it works as well for back pain. Still, each case is unique. So just because it hasn’t been found to be the most effective remedy in clinical trials doesn’t mean it won’t help you.

Risks: It can damage the liver if it’s taken in high doses. That’s why doctors advise taking around 3,000 milligrams (mg) a day even though the maximum daily dose (according to the FDA) is 4,000 mg.

NSAIDs (Aspirin, Ibuprofen, Motrin)

Nonsteroidal anti-inflammatory drugs are alternatives to acetaminophen that you can buy without a prescription. They help fight swelling and fever.

Risks: NSAIDs can cause digestive problems like nausea and diarrhea, as well as heartburn and stomach pain. Rarely, they can have serious side effects like internal bleeding and ulcers. They may also cause heart problems and kidney damage.

Muscle Relaxants

In some cases, your doctor might prescribe these for your low back pain. Some of the most commonly used muscle relaxants are Cyclobenzaprine (Flexeril), Metaxalone (Skelaxin), and Tizanidine (Zanaflex). These drugs work by helping to ease spasms in the muscles.

Risks: Muscle relaxants carry a big risk of side effects, like drowsiness and dizziness.

Antidepressants

These might be an option if your pain is neuropathic -- meaning it shoots down your leg. But you probably won’t see results right away. Most people get moderate relief after taking these meds for several weeks.

These are the most commonly prescribed antidepressants for low back pain:

Risks: While taking antidepressants, you might experience drowsiness, dizziness, dry mouth, and constipation.

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Opioids

Doctors sometimes prescribe these for low back pain. But recent research shows that they usually only provide short-term relief. And they carry a lot of risks, like hormonal changes and dependency. For this reason, doctors don’t usually prescribe them for chronic, or long-term, pain. If yours does, he’ll also likely recommend other therapies, like exercise or lifestyle changes. And, he’ll monitor you regularly to make sure they’re easing your pain and improving your function without causing harm.

Risks: Aside from the possible side effects mentioned above, opioids can also cause nausea and constipation in the short term. Over time, they can lead to depression and sexual dysfunction.

WebMD Medical Reference Reviewed by Lisa Bernstein, MD on October 14, 2016

Sources

SOURCES:

Harvard Health Publications: “Best Bets for Back Pain.”

Arthritis Foundation: “Medications to Treat Back Pain.”

Cochrane Library: “Muscle Relaxants for Non-Specific Low-Back Pain.”

Annals of Internal Medicine: “Medications for Acute and Chronic Low Back Pain: A Review of the Evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline

Mayo Clinic: “Antidepressants: Another Weapon Against Chronic Pain.”

JAMA: “Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain.”

BMJ: “Opioids for Low Back Pain.”

Chou, R.: “Approach to Use of Opioids in Patients With Low Back Pain.”

Medscape: “Opioid Analgesics Subpar for Chronic Back Pain.”

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