Medications used to treat low back pain typically include acetaminophen, NSAIDs, oral steroids, narcotic drugs, and muscle relaxants. Each medication comes with unique mechanisms of action and risks, and a patient’s symptoms and overall health will determine which pain reliever should be used. Some patients may find that they need to try a few different types of medication, and/or different dosages, to find what works best for them.
Acetaminophen (e.g. Tylenol) works by reducing the brain’s perception of pain. It does not treat the inflammation that may be causing the pain. Acetaminophen is frequently recommended because it has relatively few side effects and can be obtained without a prescription.
NSAIDs, non-steroidal anti-inflammatory drugs, are a group of drugs that are designed to reduce the inflammation in the low back that may be causing pain. NSAIDs are found in both over-the-counter and prescription forms. The most commonly used are Ibuprofen (e.g. Advil, Motrin), Naproxen (e.g. Aleve), and COX-2 inhibitors (prescription Celebrex). NSAIDs should be taken regularly at the appropriate dosage for the best relief. Doctors sometimes recommend taking NSAIDs with acetaminophen to address both the pain and inflammation.
Oral steroids are prescription anti-inflammatory medications used to treat low back pain. Prescription dosages often start out high to kick-start the relief, then gradually decreases over 5-6 days, because extended steroid use is knowingly related to many side effects and complications.
Narcotic pain medications are typically reserved for severe back pain and tend to be used on a short-term basis because they lose their effectiveness if taken for a long period of time and can be addictive. Narcotics work by dissociating the individual from having the feeling of pain. Common prescriptions include codeine (e.g. Tylenol #3), propoxyphene (e.g. Darvocet), hydrocodone (e.g. Vicodin), and oxycodone (e.g. Percocet, Oxycontin).
Muscle relaxants work by having an overall sedative effect on the body. They are typically prescribed early in the course of treatment to alleviate the pain caused by muscle spasms. Common prescriptions include Soma, Flexeril and Valium.
In addition to the above, many other common forms of pain medications may be prescribed for low back pain, including anti-depressants, tramadol (e.g. Ultram), transdermal patches, and more.
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