Learn about drugs that can offer back pain relief and help you get back on your feet again.

When seeking back pain relief, medication might be one of the first steps you try. Many different types of medications have been proven to be successful for back pain treatment, and the type you need depends on the type of pain you have.

Back Pain Treatment: Explore Your Medication Options

"Generally, for the treatment of back pain, a stepwise approach should be considered," says Bradley Hein, PharmD, an assistant professor of pharmacy at the James L. Winkle College of Pharmacy, University of Cincinnati. "Often, patients will try over-the-counter pain relievers before seeking further treatment from a physician. It is important to establish what a patient has tried as well as what has and has not worked."

Medications for back pain relief include:

• Acetaminophen: "It is reasonable to initiate treatment with acetaminophen (Tylenol)," Hein says. "Acetaminophen is widely available, effective for many, safe in recommended doses, and cheap. There are very few side effects. One concern is consistent use of greater than 4,000 milligrams a day can lead to liver toxicity."
• Non-steroidal anti-inflammatory drugs (NSAIDs): These drugs are most effective in treating pain that affects the bones or muscles, and therefore are effective for back pain relief. "Non-steroidal anti-inflammatory medications are also widely available without prescription and effective for the treatment of back pain," Hein says. "NSAIDs provide an additional anti-inflammatory component that acetaminophen does not provide."

  "NSAIDs include medications such as ibuprofen (Motrin, Advil) and naproxen (Alleve)," he adds. "For short-term use (less than seven days), these medications are pretty safe. However, there is the possibility of serious side effects with long-term use, such as kidney failure and stomach ulceration and bleeding. NSAIDs can also worsen pre-existing conditions, such as high blood pressure and heart failure."

• Narcotic painkillers: These medications are typically prescribed by a doctor, and include codeine, oxycodone, hydrocodone, and morphine. There are many common side effects with narcotic medications, including "constipation, sedation, confusion, nausea, decreased respirations, urinary retention, and allergic reactions," Hein says. "Also, each of these medications can be habit-forming and therefore it is important to use these medications for a short time period and treat the underlying cause."
• Muscle-relaxing medications: These medications are directed at the muscles rather than the central nervous system as a whole. Some commonly prescribed muscle relaxants are carisoprodol (Soma, Vanadom) and cyclobenzaprine (Flexeril). There is a risk of forming a habit with these medications as well, so use them only under the close supervision of your doctor.
• Adjuvant medications: Adjuvant medications are those not typically prescribed as pain relievers but which might be prescribed in combination with other drugs as a back pain treatment. For back problems, they are often prescribed for pain that is related to the nerves. Adjuvant medications can include antidepressants, anticonvulsants, and beta blockers (commonly used to treat high blood pressure).
• Anesthetics: These medications provide back pain relief by blocking an affected nerve surrounding the spinal cord. Over-the-counter creams might be used to anesthetize the area, or local anesthetics such as lidocaine and procaine hydrochloride (Novocaine) may be administered.
• Steroids: These anti-inflammatory medications can treat back pain caused by inflammation. Though safe when taken for short periods of time, side effects and complications can occur when steroids are taken for longer than two weeks. Side effects can include decreased production of the hormone cortisol, which can lead to more infections, weight gain, and swelling. Other complications from steroids might include higher blood sugar levels in diabetics, and osteoporosis.

“There are various medications that may be helpful, depending on the source of the pain," says William O. Witt, MD, pain specialist at the University of Kentucky and director of UK HealthCare's Interventional Pain Associates. "Often, medications useful in treating arthritis are also beneficial in treating back pain due to degeneration. Tylenol is often helpful and can be used along with other analgesics. The narcotics have not been shown to be useful in controlled studies, although there may be individuals who benefit. Their use remains highly controversial."

Remember that any drug might interact with another drug you are taking — or even with a vitamin or other supplement. Always talk to your doctor before starting any new medications to treat back pain, and always follow your doctor's prescription orders for taking your medications.