Pain medications—prescription and nonprescription—are important in the management of acute lower back pain, but they are not generally considered to be good long-term solutions for chronic lower back pain. Drugs that may be useful in the treatment of lower back pain include the usual classes of pain relievers:

  • Over-the-counter (OTC) analgesics (aspirin, acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs): Aspirin is able to relieve pain, lower fever, and reduce inflammation. Acetaminophen has very little anti-inflammatory action but is a time-proven analgesic with few side effects and less potential to cause stomach problems than aspirin. Over-the-counter NSAIDs include ibuprofen (Motrin ®, Advil ® ) and naproxen (Naprosyn ®, Aleve ® ).
  • Prescription NSAIDs: If OTC analgesics and anti-inflammatory medications are not effective, your doctor may prescribe a stronger, prescription-only NSAID, such as indomethacin (Indocin ® ) or ketoprofen (Oruvail ® ). There are many prescription-only NSAIDs.
  • Steroidal anti-inflammatories — Prednisone is the most frequently prescribed steroid. Prolonged use of steroidal anti-inflammatories is a problem, however, because they increase susceptibility to infection and can produce a number of unpleasant side effects.
  • Narcotic analgesics — There are many narcotic analgesics and formulations combining a narcotic with other analgesics.

    • Opioids are among the most commonly used narcotics for lower back pain. They include drugs such as codeine, oxycodone (OxyContin ® ), and morphine. All opioids are prescription only and classified as controlled substances because they can be addictive.
    • Short courses of opioids may be prescribed in cases of severe acute or chronic lower back pain. Many specialists believe that long-term use of opioids is detrimental to back pain patients, perhaps promoting depression and even increasing back pain.

  • Muscle relaxants — Muscle relaxants produce sedation and relaxation but have no analgesic or anti-inflammatory properties. A common example of a muscle relaxant is diazepam (Valium ® ).

Advil ® is a registered trademark of Wyeth Consumer Healthcare. Aleve ® is a registered trademark of Bayer Healthcare.
Indocin ® is a registered trademark of Merck & CO., Inc.
Motrin ® is a registered trademark of McNeil Consumer & Specialty Pharmaceuticals, a Division of McNeil PPC, Inc.
Naprosyn ® is a registered trademark of Roche Laboratories Inc. Oruvail ® is a registered trademark of Wyeth Pharmaceuticals.
OxyContin ® is a registered trademark of Purdue Pharma L.P.
Valium ® is a registered trademark of Roche Products Inc.