The Best Meds for Back Pain

Find the right medications for you and use them correctly.

Back pain is a common experience for nearly everyone, with around 80% of people seeking medical attention for it at some point. While over-the-counter pain relievers are often effective, it raises the question of whether medication is the optimal solution for managing routine episodes of back pain.

According to Dr. Robert Shmerling, formerly the clinical chief of rheumatology at Harvard-affiliated Beth Israel Deaconess Medical Center, medications can play a crucial role in managing and treating occasional or recurring pain, enabling individuals to remain pain-free and active. However, he emphasizes the importance of selecting the right medications tailored to individual needs and using them appropriately to achieve optimal results.

The source of back pain

Back pain in older men can stem from various sources, including weak core muscles, declining muscle mass, osteoarthritis, injuries, or even depression. Seeking medical attention is crucial if the pain persists, particularly if accompanied by concerning symptoms such as leg weakness, incontinence, or fever, according to Dr. Shmerling.

Notably, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may not always be the optimal approach for back pain relief. A comprehensive study published in the Annals of the Rheumatic Diseases on February 2, 2017, scrutinized 35 placebo-controlled studies involving over 6,000 individuals with spine-related pain, encompassing neck pain, low back pain, and sciatica.

Various categories of back pain medication exist, including NSAIDs, opioids, muscle relaxants, and antidepressants. Dr. Shmerling emphasizes that the effectiveness of these drugs depends on the individual’s specific pain and their body’s response to the medication and dosage.

While NSAIDs, such as ibuprofen and naproxen, are commonly recommended for back pain relief due to their ability to reduce pain, swelling, and inflammation, their overuse may lead to side effects like stomach pain, ulcers, bleeding, or kidney damage. It’s crucial to adhere to dosage guidelines and inform the doctor about medication intake.

Opioids, such as oxycodone and hydrocodone, are potent prescription drugs that interact with nerve cell receptors to alleviate pain. Although generally safe when used as prescribed and for a short duration, concerns about addiction necessitate careful consideration with a healthcare professional.

Muscle relaxants, often prescribed for acute pain with muscle spasms, may induce drowsiness, requiring cautious usage. Additionally, certain antidepressants, prescribed off-label, can assist in managing chronic low back pain. Duloxetine, used to treat depression and anxiety, has demonstrated effectiveness in treating pain without being addictive, making it a viable option for some individuals. Consulting with a doctor is essential to determine the most suitable medication based on individual needs and reactions.

Keep a pain diary

Monitoring and assessing the effectiveness of painkillers in managing back pain can be facilitated through the use of a pain diary. By maintaining a record of when pain episodes occur, their duration, and the intensity of pain on a scale from 1 to 10 (with 1 indicating minor pain and 10 representing intense pain causing immobility), individuals can gain insights into their pain patterns.

As pain medication is taken, individuals can use the same 1-to-10 scale to evaluate the impact of the medication on their pain levels. Consistently tracking these details over a week or two provides a comprehensive view of how well the painkillers are working. If there is minimal or no improvement in pain levels, it is advisable to consult with a healthcare professional for further guidance and potential adjustments to the treatment plan.