Low Back Pain

Medications

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 physiotherapy.

Medication Choices

Medicine for acute low back pain

Non-steroidal anti-inflammatory drugs (NSAIDs) that reduce pain, swelling, and irritation are the most likely to be effective for acute low back pain.³

Other medicines are used, but research has not proven them to be helpful. These include:³

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

Muscle relaxants are also used sometimes, but they can have significant side effects, such as drowsiness. Some people develop a dependence on the drug. For some people, the benefit from muscle relaxants is not worth the risk of side effects or dependence.³

Medicine for chronic low back pain

There are no medicines that have been proven to reliably decrease chronic back pain, but several medicines are likely to be beneficial. These include:⁶

• Painkillers (acetaminophen, opiates).
• Non-steroidal anti-inflammatory drugs (NSAIDs).
• Anesthetic or corticosteroid injections.

Antidepressants (such as tricyclics), muscle relaxants, epidural corticosteroid injections, and anticonvulsants 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.⁶

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.⁶

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.

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

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Author:	Douglas Dana Shannon Erstad, MBA/MPH	Last Updated: April 3, 2006
Medical Review:	William M. Green, MD - Emergency Medicine Tom Bailey, MD - Family Medicine Kathie Hummel-Berry, PT, PhD - Physical Therapy Robert B. Keller, MD - Orthopedics
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