Medications for back pain are either over the counter drugs (OTC) or prescription medications. Prescription medications are stronger and used for more severe back pain. They are prescribed by a physician and like most drugs come in name brand or generic form (generics are less expensive).  Over the counter medications can be purchased in any pharmacy and do not require a prescription. They are generally used for milder forms of back pain. Patients should consult a physician anytime they are taking pain medication consistently for more than two weeks.

Popular OTC pain medications:

Nonsteroidal anti-inflammatory drugs (NSAID) are widely used for many types of pain including back pain.  If taken in a therapeutic dose they are also affective at controlling inflammation. The quantities of NSAIDs that constitute a therapeutic dose however are enough to cause stomach and digestion problems in some patients. NSAIDs should be taken with meals to help avoid stomach problems. NSAIDs should not be used long term (more than 2 weeks) without consulting a physician.

Common OTC NSAIDs:

• Aleve (Naproxen Sodium)
• Advil (Ibuprofen)

NSAIDs also come in high dosage prescription strength. High dosage NSAIDs are what most physicians prescribe for patients who require the anti-inflammatory properties of NSAIDs. Some of the adverse side effects of high dosage NSAIDs are: nausea, constipation, diarrhea and sensitivity to light.

Two of the more serious risks of NSAIDs are:

• Kidney damage. NSAIDs are flushed out of the body by the kidneys. Patients over 65 years of age or patients with kidney problems must first consult a physician before taking NSAIDs. Patients who take NSAIDs for six months or more should have a blood test to check for signs of kidney damage.

• Stomach problems. NSAIDs may also cause stomach problems or occasionally stomach ulcers. Patients who have had stomach ulcers in the past should consult with their physician before using NSAIDs. Symptoms of a stomach ulcer or intestinal bleeding may include: abdominal pain, black tarry stools, muscle weakness, or light-headedness when standing up.

NSAIDs have a number of other risks and complications. While such side effects are rare, some can be serious. It is important for patients to be under the supervision of a physician when taking NSAIDs for extended periods or in high dosages.

Patients with these existing problems should consult their physician before taking NSAIDs:

• Thyroid problems
• Diabetes
• Heart disease
• High blood pressure
• Allergies to aspirin or pain relievers
• Pregnant or breast feeding
• Consume more then three alcoholic beverages a day
• About to have surgery (including dental surgery)

Acetaminophen, known most commonly as Tylenol, is a widely used OTC medication for pain relief. It is also called Paracetamol. It has no anti-inflammatory properties but is a safe choice for mild back pain relief. It has no adverse side effects on the stomach or digestive system but patients should be wary of taking Acetaminophen long term due to possible liver damage.

Prescription medications for back pain

Prescription medications for back pain include:

• Muscle relaxors
• Steroid anti-inflammatories
• Pain killers

Muscle relaxors are prescribed for patients who have severe muscles spasms along with their back pain. Muscles spasms that are associated with back problems can be excruciating. This is because the back muscles contract (spasm) so intensely in reaction to the spine injury that they cut off their own blood supply. this creates an ischemic condition (no oxygen) in the muscles. This lack of oxygen to the muscle cells creates a muscle pain on top of the pain coming from the spine.

Common prescription muscle relaxors:

Flexeril (Cyclobenzaprine Hydrochloride) Skeletal Muscle Relaxant

Skelaxin (Metaxalone) muscle relaxant

Soma (Carisoprodol) muscle relaxant

Oral Steroid Anti-inflammatories

Oral steroids are mostly used to help reduce inflammation associated with a bulged or herniated disc.  Much of the pain and nerve symptoms that occur with disc problems are due to the accompanying inflammation in the surrounding ligaments and soft tissues. If this inflammation can be reduced the symptoms often resolve even if there is a disc bulge. At the very least the reduction in pain and inflammation enables patients to participate in other conservative treatments such as physical therapy. Oral steroids for low back pain are generally prescribed in what is known as a Medrol Dose Pack. This is a regimen of taking the pill that starts with a high dose to initiate the anti-inflammatory impact of the medication and delver some immediate low back pain relief. The dose then tapers off to a lower dose over five or six days. Chronic steroid use leads to numerous complications. Therefore the use of oral steroids is limited to short period of time (one to two weeks) and is typically used only for severe or intractable back pain flair ups.

The most common oral steroid is Prednisone (Methylprednisolone)

Prescription Painkillers For Back Pain

Prescription painkillers for low back pain are generally narcotics and therefore can be highly addictive if taken for an extended period. Patients can easily become tolerant to the pain relieving affects of these narcotics. This means that higher doses are required to relieve pain the more they are used. Therefore these medications are generally reserved for acute bouts of severe pain and are prescribed for short periods of time, two weeks or less.

Prescription Drugs Commonly Prescribed For Back Pain

OxyContin (Oxycodone Hydrochloride) narcotic painkiller (highly addictive)

Percocet (Oxycodone Hydrochloride & Acetaminophen) narcotic painkiller (highly addictive)

Vicodin (Acetaminophen and Hydrocodone) narcotic painkiller (highly addictive)

Ultram (Tramadol). This medication is a non-narcotic painkiller that is stronger than Tylenol (acetaminophen) but not as potent as the above narcotic painkillers. Ultracet is a brand of painkiller that has both Tramadol and Acetaminophen. Patients taking Ultracet should not need to take any additional acetaminophen (Tylinol).