When experiencing back pain, finding the right treatment can make all the difference. Some medications are more suitable for short-term use, while others may be more effective in the long term.
Your doctor will consider the risks and benefits of any medication for specific situations. You can work with them to create a treatment plan that includes medications and possibly other treatments like exercise, physical therapy, or chiropractic care.
It’s important to take medications as directed and tell your doctor about all medications and supplements you are taking.
Read on to learn more about common medications for back pain. Discussing your symptoms, medical history, and lifestyle habits with a doctor can help determine the right medication for you.
Nonsteroidal anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most widely prescribed medications for back pain.
Most NSAIDs are available as oral medications, including:
- ibuprofen (Advil)
- acetaminophen (Tylenol)
- naproxen (Aleve)
Some NSAIDs may be injectable or topical.
NSAID medications decrease inflammation and provide pain relief by inhibiting (blocking) an enzyme called cyclooxygenase (COX). This enzyme has two forms, COX-1 and COX-2.
Severe NSAID side effects are not usually common, but can include:
- stomach upset, especially with those that inhibit COX-1, as this enzyme is important in protecting membranes in the stomach
- bleeding, especially in people who have a history of gastric ulcers or diseases that affect platelets
- kidney damage, especially in people who already have compromised kidney function
People who have known allergic reactions to NSAIDs or aspirin, those in the third trimester of pregnancy, and those who have undergone coronary artery bypass grafts should not take NSAIDs.
Acetaminophen is the active ingredient in Tylenol and is a widely used pain relief medication worldwide. It’s often the first medication recommended to treat mild to moderate pain.
Acetaminophen’s mechanism of action is not completely understood, but it may raise the pain threshold by decreasing a neurotransmitter called substance P. This neurotransmitter affects the way pain signals are regulated in the body.
Acetaminophen can also inhibit the COX pathway, which plays a big role in inflammatory pain. However, NSAIDs may do this more.
According to 2019 research, some studies have shown that acetaminophen has little effect on back pain. A 2020 review suggested that acetaminophen has fewer side effects than NSAIDs, especially when it comes to stomach issues. However, it also found that NSAIDs could be more effective because of their anti-inflammatory effects.
For pregnant people, acetaminophen is a preferable pain reliever to NSAIDs.
Doctors commonly prescribe several categories of antidepressant medications for back pain. These include:
These medications are endorsed by 75% of clinical guidelines for the treatment of lower back pain. However, a 2021 analysis of 33 studies done on 5,318 people with chronic back, hip, or knee pain showed them to be largely ineffective. The study did show a small positive effect on osteoarthritis pain.
Some of these medications may also have significant side effects. Stopping them abruptly can cause withdrawal symptoms like:
- nausea
- constipation
- dizziness
- drowsiness
- fatigue
- mood changes
- issues with sleep
- weight gain
- headaches
In the past, anticonvulsant medications were used to treat chronic back pain. This might have been due to the need for alternatives to opioid medication, due to the risk of addiction.
Anticonvulsants used for back pain include:
- gabapentin (Neurontin)
- pregabalin (Lyrica)
- topiramate (Topamax)
Effectiveness and side effects
A 2022 systematic review suggested that there was insufficient evidence to demonstrate the effectiveness of anticonvulsants in alleviating back pain.
They also have a risk of side effects, including drowsiness, dizziness, and nausea.
Skeletal muscle relaxants are a class of drugs that relieve spasms, which can be extremely painful.
Muscle relaxants are prescribed extensively for back pain. It is often recommended to use them temporarily for acute pain rather than on a long-term basis.
Muscle relaxants that act by diminishing the strength of muscle spasms locally include benzodiazepines such as:
- diazepam (Valium)
- lorazepam (Ativan)
- alprazolam (Xanax)
This also includes skeletal muscle relaxants such as:
- cyclobenzaprine (Flexeril, Amrix)
- orphenadrine (Norflex)
- methocarbamol (Robaxin)
Muscle relaxants that act on the central nervous system to lower spasticity include baclofen (Lioresal) and dantrolene (Dantrium).
Effectiveness and precautions
There is debate about the effectiveness of muscle relaxants for back pain. A 2025 meta-analysis found that benzodiazepines were beneficial for the short-term treatment of pain and muscle spasms. However, there is some debate over whether they are more effective than other medication like NSAIDS or analgesics. That same meta-analysis suggested that a combination of muscle relaxants with NSAIDS or analgesics could be more beneficial than NSAIDS or analgesics on their own. However, more research is needed.
Many of these medications have a high potential for abuse, so if a doctor prescribes you one of these medications, use it cautiously. They can decrease coordination and make you clumsy. Also, most of these medications have sedative effects, so don’t drive or operate machinery until you know how they will affect you.
Never mix muscle relaxants with recreational drugs or alcohol.
Opioids are narcotic medications that act by depressing pain signals in the central nervous system. They do not treat the cause of the pain directly. Instead, they bind to receptors in the brain and spine.
Opioid medications include:
- morphine
- hydromorphone (Dilaudid)
- oxycodone (OxyContin, Percocet)
- meperidine (Demerol)
- codeine
- fentanyl
- hydrocodone (Vicodin, Norco, Lortab)
- oxymorphone (Opana)
Opioid medications are controlled substances and are highly regulated. This is because these medications may cause addiction. These medications are meant for short-term use only.
Also, because these medications depress the central nervous system function, they can lower the respiratory drive. This can cause people to have low respiratory rates or stop breathing.
Other side effects include constipation, drowsiness, confusion, and depression.
If you take opioids, keep your medication secure and away from other people. Use it only as directed and for the shortest time possible.
You should also keep a naloxone kit close by in case of accidental overdose. Naloxone is a medication that reverses the effects of opioids. The kit contains a nasal spray form of the medication that is easy to administer.
In 2025, the Food and Drug Administration (FDA) approved the first non-opioid analgesic, suzetrigine (Journavx), for the treatment of moderate to severe pain among adults. This is the first type of drug to be approved in this group of pain management medications.
Suzetrigine blocks sodium channel pathways in the nervous system that send pain signals to the brain.
The most common side effects of this medication are:
- rash
- an increased blood level of creatine phosphokinase (an enzyme that helps create chemical reactions)
- muscle spams
- itchiness
- vomiting
- nausea
People taking strong cytochrome P34A (CYP3A) inhibitors are not advised to take suzetrigine, and the medication can also interfere with hormonal birth control. It’s important to talk with your doctor to make sure this is the right medication for you. This medication can’t be taken with food or drinks that contain grapefruit. It’s not recommended to take this medication for longer than 14 days.
Oral corticosteroids are medications that can help reduce inflammation throughout the body. Doctors commonly prescribe them for back pain, but a 2023 review suggested that their effectiveness was modest. Oral steroid medications include:
- prednisone (Deltasone)
- prednisolone (Orapred, Prelone)
- dexamethasone (Decadron, Hexadrol)
- hydrocortisone
- methylprednisolone (Medrol)
- cortisone acetate
- budesonide oral suspension (Eophilia)
Oral steroids also have side effects, some of which may be serious. These include:
- infection
- bone loss and osteoporosis
- death of bone tissue in joints
- weight gain
- elevated blood sugars
- breakdown of muscle tissue
- high blood pressure
- edema (fluid) in legs and feet
- skin changes, such as:
- thin skin
- bruising easily
- issues with wound healing
- cataracts
- stomach irritation and ulcers
- motor restlessness
- sleep problems
Rubs, patches, and creams with various active ingredients are available for managing back pain. These include:
These medications may help alleviate pain associated with muscle strains, muscle sprains, and arthritis. Some of them may be toxic in high amounts and may be absorbed through the skin. Apply them as directed and avoid applying to broken skin.
Several other categories of medications can help treat back pain. These include:
- disease-modifying antirheumatic drugs (DMARDs), which treat various types of arthritis
- biologics and biosimilars, which stop inflammation at a particular part of the inflammatory process
- osteoporosis medications, which slow bone loss or help the body build new bone
When to see a doctor for back pain
Contact your doctor for back pain that:
- doesn’t improve after 6 weeks
- occurs after an injury or fall
- is severe and isn’t helped with medication
- is accompanied by weakness, numbness, or tingling in your arms or legs
- is accompanied by fever
- is accompanied by loss of bowel or bladder control
- happens along with unexplained weight loss
Back pain can be complex and hard to manage, but treatments are available. The right medication for you will depend on the cause of your pain, how long you have had the pain, and other medical conditions you may have.
Take all medications exactly as directed. Secure any opioid medications, preferably in a locked box. Tell your doctor about all medications and supplements you are currently taking.