Table of ContentsView AllTable of ContentsOTC Pain RelieversPrescription Pain RelieversOther Pain Relief Methods
Table of ContentsView All
View All
Table of Contents
OTC Pain Relievers
Prescription Pain Relievers
Other Pain Relief Methods
Lower back paincan affect one’s ability to move comfortably and function throughout the day. Medications, including over-the-counter (OTC) and prescription drugs, are available to manage pain and provide relief.
However, what medication you use depends on factors such as how bad the pain is, how long it’s been there, and why it’s happening. Pain can be acute (lasting less than one month),chronic(lasting more than three months), or subacute (lasting somewhere between one to three months). The type of lower back pain you’re experiencing may affect your treatment.
This article will discuss common medication options for lower back pain relief.
Getty Images / urbazon
Over-the-Counter Medications for Lower Back Pain
You may choose OTC medicines to help with lower back pain, especially if the pain feels mild to moderate. They’re also suitable for short-term use and are cheaper and easier to pick up since there’s no healthcare visit required. You can buy them at most stores without a prescription.
OTC medicines include certain drugs like nonsteroidal anti-inflammatory drugs (NSAIDs) andTylenol (acetaminophen). Examples of OTCNSAIDsare Advil or Motrin (ibuprofen) and Aleve (naproxen sodium).
Topical Medications for Low Back PainTopical medications are also available for pain relief. These products come in gels, creams, and patches applied to the skin. Topical medications can also often be used with oral medications.Examples of topical pain relief medications include:MentholMenthol, methyl salicylate, and camphorLidocaineVoltaren Arthritis Pain (diclofenac)
Topical Medications for Low Back Pain
Topical medications are also available for pain relief. These products come in gels, creams, and patches applied to the skin. Topical medications can also often be used with oral medications.Examples of topical pain relief medications include:MentholMenthol, methyl salicylate, and camphorLidocaineVoltaren Arthritis Pain (diclofenac)
Topical medications are also available for pain relief. These products come in gels, creams, and patches applied to the skin. Topical medications can also often be used with oral medications.
Examples of topical pain relief medications include:
Tylenol (Acetaminophen)
Tylenol isn’t an opioid—it’s a different kind of pain reliever. It can be beneficial for managing acute pain because it has few side effects.
You can use Tylenol for headaches, muscle aches, toothaches, backaches, and cramps during periods. It’s also used for joint pain in the hands or knees (osteoarthritis) andrheumatoid arthritis. And it’s often used to lower fevers in adults and children.
Tylenol is usually safe, but it’s important to know about possible side effects, such as:
Always follow the right dose and talk to your healthcare provider if something doesn’t feel right. For adults without liver problems, the package insert recommends no more than 10 tablets (3,250 milligrams) a day.
If you have had liver problems or drank excessive amounts of alcohol in the past, you should be careful using Tylenol because it might stress your liver more. Avoid using Tylenol for a long time without talking to your healthcare provider.Your provider may also recommend a lower maximum daily dose.
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Nonsteroidal Anti-Inflammatory Drugs
Safety Considerations with NSAIDsNSAIDs can heighten the risk for severe and potentially life-threatening heart problems, like heart attack or stroke. This risk is increased with higher doses and longer durations of use. If you have a history of heart problems, NSAIDs may not be the right choice for you.NSAIDs can also causeulcersor bleeding in the stomach or intestines. This risk is higher for people who are older, smoke, or drink large amounts of alcohol.Stop taking your medication if you have severe stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, or bloody, black, or tarry stools.
Safety Considerations with NSAIDs
NSAIDs can heighten the risk for severe and potentially life-threatening heart problems, like heart attack or stroke. This risk is increased with higher doses and longer durations of use. If you have a history of heart problems, NSAIDs may not be the right choice for you.NSAIDs can also causeulcersor bleeding in the stomach or intestines. This risk is higher for people who are older, smoke, or drink large amounts of alcohol.Stop taking your medication if you have severe stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, or bloody, black, or tarry stools.
NSAIDs can heighten the risk for severe and potentially life-threatening heart problems, like heart attack or stroke. This risk is increased with higher doses and longer durations of use. If you have a history of heart problems, NSAIDs may not be the right choice for you.
NSAIDs can also causeulcersor bleeding in the stomach or intestines. This risk is higher for people who are older, smoke, or drink large amounts of alcohol.
Stop taking your medication if you have severe stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, or bloody, black, or tarry stools.
Nonsteroidal anti-inflammatory drugs, also called NSAIDs, are medications that many people use to ease pain, often related toarthritis, headaches, cramps, and muscle aches. This means they could be a suitable option if you’re experiencing lower back pain. NSAIDs come in different forms, like tablets, creams, and gels.
Even though NSAIDs are usually safe, there can be side effects and issues, such as:
People with a history of stomach bleeding, kidney problems, or heart issues should talk to their healthcare provider before taking NSAIDs.
A Word From VerywellFor some people, if one NSAID does not work for them, it does not mean that all NSAIDs will not work for them. Some NSAIDs are more selective to certain components of the body and may be better suited for a patient’s individual needs.—ERIKA PROUTY, PHARMD, MEDICAL EXPERT BOARD
A Word From Verywell
For some people, if one NSAID does not work for them, it does not mean that all NSAIDs will not work for them. Some NSAIDs are more selective to certain components of the body and may be better suited for a patient’s individual needs.—ERIKA PROUTY, PHARMD, MEDICAL EXPERT BOARD
For some people, if one NSAID does not work for them, it does not mean that all NSAIDs will not work for them. Some NSAIDs are more selective to certain components of the body and may be better suited for a patient’s individual needs.
—ERIKA PROUTY, PHARMD, MEDICAL EXPERT BOARD
Prescription Pain Medications for Lower Back Pain
While OTC relievers may help with mild or moderate pain, more severe pain might require stronger medications that your healthcare provider can prescribe. You might need a prescription-strength medication if you have severe or long-lasting lower back pain or if there are other medical issues involved, like cancer or nerve pain.
For example, healthcare providers might prescribe opioids like oxycodone or muscle relaxants for severe pain after surgery or for intense pain.
Muscle Relaxants
Muscle relaxantshelp ease lower back pain from muscle spasms. These spasms can happen due to injuries, conditions likefibromyalgiaor multiple sclerosis, or as a side effect of other treatments. Muscle relaxants are a common choice for healthcare providers, especially for low back pain.They can also be combined with OTC medications.
Some examples of skeletal muscle relaxants are baclofen, Zanaflex (tizanidine), and Robaxin (methocarbamol).
You might take muscle relaxants for sudden back pain, sprains, or conditions like fibromyalgia or multiple sclerosis. They can ease muscle spasms and help manage pain better for sudden back pain. In conditions like fibromyalgia, they can ease muscle pain. But usually, they’re part of a plan that includes other things like exercise or physical therapy.
Muscle relaxants can cause side effects like:
Muscle relaxants may also interact with other medications, like sedatives, so it’s best to be careful when using them together.
NSAIDs
Prescription-strength NSAIDsare available to help manage pain that is too severe to treat with OTC medications. They can be used for pain or inflammation associated with health conditions such as arthritis orankylosing spondylitisor for injuries like muscle sprains or strains.
Examples of prescription NSAIDs include:
Opioids
Opioidsare effective at easing pain because they attach to opioid receptors in the body that block or reduce pain signals. However, they can lead tosubstance use disorderand other serious health problems, so it’s important to be careful when taking them. For this reason, healthcare providers usually only prescribe them when other pain relievers aren’t enough.
Some examples of commonly used opioids include morphine, oxycodone, and fentanyl.
Opioids are helpful for managing severe pain, like after surgery or injuries.
They have some side effects related to them. Common side effects are:
Opioids don’t mix well with certain drugs, likebenzodiazepines. The combination can make you more tired or slow your breathing to the point of respiratory depression. Talk to your healthcare provider about the safety considerations and potential drug interactions with opioids before starting treatment.
Antidepressants
Antidepressantsaren’t just for mental health conditions like depression or anxiety—they can also be used for reducing lower back pain.
Two common types of antidepressants areserotonin and norepinephrine reuptake inhibitors (SNRIs), likeCymbalta (duloxetine), and tricyclic antidepressants (TCAs), such asamitriptylineand Pamelor (nortriptyline).
Common side effects related to SNRIs are:
Common side effects related to TCAs are:
It’s important to be cautious with TCAs if you have certain heart problems. Also, combining them with other medications that affect serotonin levels can cause a serious condition calledserotonin syndrome.
Cymbalta RecallStarting in October 2024, over 200,000 bottles of duloxetine delayed-release capsules were recalled over concerns about the presence of nitrosamines, which can increase the risk of cancer.If you take duloxetine, check your medication packaging to see if it was part of the affected lots or call your pharmacist to find out. You should also contact your prescriber, as abruptly stopping a medication like duloxetinecan be dangerous.The recalled lots have expiration dates from November 2024 to December 2025. You can check the lot numbers in the FDA enforcement reports released inOctoberandDecember.
Cymbalta Recall
Starting in October 2024, over 200,000 bottles of duloxetine delayed-release capsules were recalled over concerns about the presence of nitrosamines, which can increase the risk of cancer.If you take duloxetine, check your medication packaging to see if it was part of the affected lots or call your pharmacist to find out. You should also contact your prescriber, as abruptly stopping a medication like duloxetinecan be dangerous.The recalled lots have expiration dates from November 2024 to December 2025. You can check the lot numbers in the FDA enforcement reports released inOctoberandDecember.
Starting in October 2024, over 200,000 bottles of duloxetine delayed-release capsules were recalled over concerns about the presence of nitrosamines, which can increase the risk of cancer.If you take duloxetine, check your medication packaging to see if it was part of the affected lots or call your pharmacist to find out. You should also contact your prescriber, as abruptly stopping a medication like duloxetinecan be dangerous.
The recalled lots have expiration dates from November 2024 to December 2025. You can check the lot numbers in the FDA enforcement reports released inOctoberandDecember.
Other Ways to Manage Low Back Pain
When treating lower back pain, many healthcare providers first think of treatments without medications. Using ice or heat, massages,acupuncture, or spine adjustments are good options for lower back pain.
For chronic pain, exercises for the mind and body, likeyogaor tai chi, may be helpful.
Summary
When choosing a medication to help relieve lower back pain, consider the severity and underlying cause.
Each of these medications works differently and has its place in pain treatment. You may only need one for quick relief or require a longer-term treatment plan involving other methods, such as physical therapy or acupuncture.
Everyone responds differently to pain and pain medications. For this reason, work closely with your provider to determine the right treatment path for you. Factors like age, other health problems (comorbidities), and what a person wants from the treatment are also considered.
The author would like to recognize and thank Norma Ponce, PharmD, MHA, for contributing to this article.
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Dowell D, Ragan KR, Jones CM, et al.CDC clinical practice guidelines for prescribing opioids for pain — United States, 2022.MMWR Recomm Rep. 2022;71(3);1-95.DailyMed.Label: Menthol cream.DailyMed.Label: pain relief patches- camphor, menthol, methyl salicylate patch.DailyMed.Label: lidocaine patch.DailyMed.Label: Voltaren- diclofenac sodium gel.DailyMed.Label: Tylenol regular strength- acetaminophen tablet.Jóźwiak-Bebenista M, Nowak JZ.Paracetamol: mechanism of action, applications and safety concern.Acta Pol Pharm. 2014;71(1):11-23.MedlinePlus.Ibuprofen.Cashin AG, Folly T, Bagg MK, et al.Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis.BMJ. 2021;374:n1446. doi:10.1136/bmj.n1446DailyMed.Label: baclofen tablet.DailyMed.Label: morphine sulfate capsule, extended release.Ferreira GE, McLachlan AJ, Lin CC, et al.Efficacy and safety of antidepressants for the treatment of back pain and osteoarthritis: systematic review and meta-analysis.BMJ. 2021;372:m4825. doi:10.1136/bmj.m4825Santarsieri D, Schwartz TL.Antidepressant efficacy and side-effect burden: a quick guide for clinicians.Drugs Context. 2015;4:212290. doi:10.7573/dic.212290MedlinePlus.Duloxetine.Wang SM, Han C, Bahk WM, et al.Addressing the side effects of contemporary antidepressant drugs: a comprehensive review.Chonnam Med J. 2018;54(2):101-112. doi:10.4068/cmj.2018.54.2.101Food and Drug Administration.What to Know and Do About Possible Nitrosamines in Your Medication.Qaseem A, Wilt TJ, McLean RM, et al.Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians.Ann Intern Med. 2017;166(7):514-530. doi:10.7326/M16-2367
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Dowell D, Ragan KR, Jones CM, et al.CDC clinical practice guidelines for prescribing opioids for pain — United States, 2022.MMWR Recomm Rep. 2022;71(3);1-95.DailyMed.Label: Menthol cream.DailyMed.Label: pain relief patches- camphor, menthol, methyl salicylate patch.DailyMed.Label: lidocaine patch.DailyMed.Label: Voltaren- diclofenac sodium gel.DailyMed.Label: Tylenol regular strength- acetaminophen tablet.Jóźwiak-Bebenista M, Nowak JZ.Paracetamol: mechanism of action, applications and safety concern.Acta Pol Pharm. 2014;71(1):11-23.MedlinePlus.Ibuprofen.Cashin AG, Folly T, Bagg MK, et al.Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis.BMJ. 2021;374:n1446. doi:10.1136/bmj.n1446DailyMed.Label: baclofen tablet.DailyMed.Label: morphine sulfate capsule, extended release.Ferreira GE, McLachlan AJ, Lin CC, et al.Efficacy and safety of antidepressants for the treatment of back pain and osteoarthritis: systematic review and meta-analysis.BMJ. 2021;372:m4825. doi:10.1136/bmj.m4825Santarsieri D, Schwartz TL.Antidepressant efficacy and side-effect burden: a quick guide for clinicians.Drugs Context. 2015;4:212290. doi:10.7573/dic.212290MedlinePlus.Duloxetine.Wang SM, Han C, Bahk WM, et al.Addressing the side effects of contemporary antidepressant drugs: a comprehensive review.Chonnam Med J. 2018;54(2):101-112. doi:10.4068/cmj.2018.54.2.101Food and Drug Administration.What to Know and Do About Possible Nitrosamines in Your Medication.Qaseem A, Wilt TJ, McLean RM, et al.Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians.Ann Intern Med. 2017;166(7):514-530. doi:10.7326/M16-2367
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Dowell D, Ragan KR, Jones CM, et al.CDC clinical practice guidelines for prescribing opioids for pain — United States, 2022.MMWR Recomm Rep. 2022;71(3);1-95.DailyMed.Label: Menthol cream.DailyMed.Label: pain relief patches- camphor, menthol, methyl salicylate patch.DailyMed.Label: lidocaine patch.DailyMed.Label: Voltaren- diclofenac sodium gel.DailyMed.Label: Tylenol regular strength- acetaminophen tablet.Jóźwiak-Bebenista M, Nowak JZ.Paracetamol: mechanism of action, applications and safety concern.Acta Pol Pharm. 2014;71(1):11-23.MedlinePlus.Ibuprofen.Cashin AG, Folly T, Bagg MK, et al.Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis.BMJ. 2021;374:n1446. doi:10.1136/bmj.n1446DailyMed.Label: baclofen tablet.DailyMed.Label: morphine sulfate capsule, extended release.Ferreira GE, McLachlan AJ, Lin CC, et al.Efficacy and safety of antidepressants for the treatment of back pain and osteoarthritis: systematic review and meta-analysis.BMJ. 2021;372:m4825. doi:10.1136/bmj.m4825Santarsieri D, Schwartz TL.Antidepressant efficacy and side-effect burden: a quick guide for clinicians.Drugs Context. 2015;4:212290. doi:10.7573/dic.212290MedlinePlus.Duloxetine.Wang SM, Han C, Bahk WM, et al.Addressing the side effects of contemporary antidepressant drugs: a comprehensive review.Chonnam Med J. 2018;54(2):101-112. doi:10.4068/cmj.2018.54.2.101Food and Drug Administration.What to Know and Do About Possible Nitrosamines in Your Medication.Qaseem A, Wilt TJ, McLean RM, et al.Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians.Ann Intern Med. 2017;166(7):514-530. doi:10.7326/M16-2367
Dowell D, Ragan KR, Jones CM, et al.CDC clinical practice guidelines for prescribing opioids for pain — United States, 2022.MMWR Recomm Rep. 2022;71(3);1-95.
DailyMed.Label: Menthol cream.
DailyMed.Label: pain relief patches- camphor, menthol, methyl salicylate patch.
DailyMed.Label: lidocaine patch.
DailyMed.Label: Voltaren- diclofenac sodium gel.
DailyMed.Label: Tylenol regular strength- acetaminophen tablet.
Jóźwiak-Bebenista M, Nowak JZ.Paracetamol: mechanism of action, applications and safety concern.Acta Pol Pharm. 2014;71(1):11-23.
MedlinePlus.Ibuprofen.
Cashin AG, Folly T, Bagg MK, et al.Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis.BMJ. 2021;374:n1446. doi:10.1136/bmj.n1446
DailyMed.Label: baclofen tablet.
DailyMed.Label: morphine sulfate capsule, extended release.
Ferreira GE, McLachlan AJ, Lin CC, et al.Efficacy and safety of antidepressants for the treatment of back pain and osteoarthritis: systematic review and meta-analysis.BMJ. 2021;372:m4825. doi:10.1136/bmj.m4825
Santarsieri D, Schwartz TL.Antidepressant efficacy and side-effect burden: a quick guide for clinicians.Drugs Context. 2015;4:212290. doi:10.7573/dic.212290
MedlinePlus.Duloxetine.
Wang SM, Han C, Bahk WM, et al.Addressing the side effects of contemporary antidepressant drugs: a comprehensive review.Chonnam Med J. 2018;54(2):101-112. doi:10.4068/cmj.2018.54.2.101
Food and Drug Administration.What to Know and Do About Possible Nitrosamines in Your Medication.
Qaseem A, Wilt TJ, McLean RM, et al.Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians.Ann Intern Med. 2017;166(7):514-530. doi:10.7326/M16-2367
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