Back Pain Medication Overview: Understanding Medication for Back Pain Relief

There are multiple over-the-counter (non-prescription) and prescription medications that can provide back pain relief. Patients considering taking any type of medication for back pain should first meet with their physician to determine their individual risk factors and appropriate treatment options.

Over-the-counter medications

The two main types of over-the-counter medications used for back pain include:

• Acetaminophen (e.g. Tylenol). Acetaminophen works by telling the brain not to feel the pain.
• Non-steroidal anti-inflammatory drugs, or NSAID’s (e.g. Advil, Motrin, Nuprin, Aleve). NSAIDs help with pain by reducing inflammation, a common component of most types of back pain.

Prescription medications

Most of the above over-the-counter medications (except acetaminophen) are also available in prescription strength. In addition, several other types of medications are also available by prescription. The most common ones include:

• COX-2 inhibitors (e.g. Celebrex). This type of NSAID helps limit inflammation, but has different risk factors than other NSAIDs. Notably, Celebrex is less likely to harm the stomach lining and cause gastric side effects. Important new information from recent studies shows a potentially increased risk for cardiovascular events (such as heart attack and stroke) for COX-2 inhibitors, and the FDA has called for further research.
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• Muscle relaxants. These are a group of different drugs that each provide an overall sedating, relaxing effect on the body, allowing the muscles to relax.
• Narcotic agents. For severe episodes of lower back pain, narcotic pain medications may be prescribed. Clearly, narcotics are strong and potentially addictive forms of medication and should only be administered by a physician. Commonly prescribed narcotics include Tylenol #3, Darvocet, Vicodin, Percocet, and Oxycontin.
• Anti-depressants. In addition to treatment for depression, certain antidepressants are sometimes prescribed as a primary treatment for chronic pain, anxiety disorders, and/or sleep disorders or insomnia. Selective Serotonin Reuptake Inhibitors (SSRI’s) are the most commonly prescribed type of anti-depressant for treatment of depression and/or chronic pain. Examples of brand name SSRI’s include Celexa, Lexapro, Prozac, Paxil, Pexeva, and Zoloft.

It is very important for patients to first consult with their physician before taking any over-the-counter or prescription medications for pain. Each medication has multiple unique risks, possible side effects and drug (or food or supplement) interactions, which need to be evaluated by a physician.

• Article written By:
• Stephen H. Hochschuler, MD

November 14, 2008

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