1. Health
You can opt-out at any time. Please refer to our privacy policy for contact information.

Choosing Effective Back Pain Medications

Pain Medication Considerations


Updated April 14, 2010

Pain is one of the most frequently reported symptoms to doctors. For back pain, medication is usually the first-line treatment. Research shows that 90% of all low back pain can be managed with acetaminophen, NSAIDs, opioids, or adjuvant medications, such as antidepressants.

Studies also reveal that no single medication reduces or eliminates pain more effectively than the others. This is true for the selection of medication classes used as a first defense (NSAIDs, Tylenol and, in some cases, mild opioids) as well as for individual drugs within classes.

Choosing a pain medication often comes down to the pros and cons of each drug, such as undesirable or desirable side effects. Different pain medications have different side effects, for example, so you'll want to pick the one that works best for you. Cost is another consideration.

Determining the best type of pain medicine for your condition could involve trial and error. You may start a medication, and find it doesn’t work, or that the side effects are just too unbearable. If this is the case, your doctor may be able to switch you to another drug in the same category.

For short-term relief of acute muscular back pain or spasm, over-the-counter NSAIDs or Tylenol and prescription muscle relaxers are effective in most cases. If you have chronic back pain, your doctor may prescribe an adjuvant medication such as an antidepressant, or a narcotic. (Narcotics are also called opioids.)

Combining pain medication with non-drug options, such as exercise or massage, also can improve long-term pain relief.

DiPalma JR, DiGregorio GJ. Management of low back pain by analgesics and adjuvant drugs. Mt Sinai J Med. 1991 Mar;58(2):101-8.

Mens JM. The use of medication in low back pain. Best Pract Res Clin Rheumatol. 2005 Aug;19(4):609-21.

Chou R, Huffman LH; American Pain Society; American College of Physicians. 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. Ann Intern Med. 2007 Oct 2;147(7):505-14

Wörz R, Müller-Schwefe G, Stroehmann I, Zeuner L, Zieglgänsberger W, Zimmermann M. Back pain: guidelines for drug therapy. Utilize the therapeutic spectrum MMW Fortschr Med. 2000 Feb 3;142(5):27-33

Luo X, Pietrobon R, Curtis LH, Hey LA. Prescription of nonsteroidal anti-inflammatory drugs and muscle relaxants for back pain in the United States. Spine. 2004 Dec 1;29(23):E531-7

Dillon C, Paulose-Ram R, Hirsch R, Gu Q. Skeletal muscle relaxant use in the United States: data from the Third National Health and Nutrition Examination Survey (NHANES III). Spine. 2004 Apr 15;29(8):892-6.

Phys Med Rehabil Clin N Am. 2003 Aug;14(3):629-41 Nemat A, Richeimer SMPharmacologic therapies for neck pain.

Schnitzer TJ, Ferraro A, Hunsche E, Kong SX. A comprehensive review of clinical trials on the efficacy and safety of drugs for the treatment of low back pain. J Pain Symptom Manage. 2004 Jul;28(1):72-95.

Mens JM. The use of medication in low back pain. Best Pract Res Clin Rheumatol. 2005 Aug;19(4):609-21.

Moulin DE. Systemic drug treatment for chronic musculoskeletal pain. Clin J Pain. 2001 Dec;17(4 Suppl):S86-93.

Langford RM. Pain management today - what have we learned? Clin Rheumatol. 2006;25 Suppl 1:S2-8. Epub 2006 Jun 2.

Schnitzer TJ. Update on guidelines for the treatment of chronic musculoskeletal pain. Clin Rheumatol. 2006;25 Suppl 1:S22-9. Epub 2006 Jun 2.

Raffa R. Pharmacological aspects of successful long-term analgesia. Clin Rheumatol. 2006;25 Suppl 1:S9-15. Epub 2006 Jun 2.

Portenoy RK. Current pharmacotherapy of chronic pain. J Pain Symptom Manage. 2000 Jan;19(1 Suppl):S16-20

Gore M, Dukes E, Rowbotham DJ, Tai KS, Leslie D. Clinical characteristics and pain management among patients with painful peripheral neuropathic disorders in general practice settings. Eur J Pain. 2007 Aug;11(6):652-64. Epub 2006 Nov 27.

Gordon DB. Nonopioid and adjuvant analgesics in chronic pain management: strategies for effective use. Nurs Clin North Am. 2003 Sep;38(3):447-64

Guindon J, Walczak JS, Beaulieu P. Drugs. 2007;67(15):2121-33. Recent advances in the pharmacological management of pain.

Related Video
How to Choose Pain Medication
  1. About.com
  2. Health
  3. Back & Neck Pain
  4. Medications
  5. Pain Medications for Back Pain - Choosing Effective Back Pain Medications

©2014 About.com. All rights reserved.

We comply with the HONcode standard
for trustworthy health
information: verify here.