What Prescription Drugs Are Used for Back Pain?
Back pain is one of the most common causes of discomfort and reduced mobility. In many cases, it improves within a few weeks with activity, exercise, and appropriate pain relief. However, persistent or severe back pain may require assessment by a doctor.
Prescription medicines are sometimes used when symptoms are severe, when over-the-counter options are unsuitable, or when a specific medical condition is causing the pain. The right medicine depends on the cause, duration, severity, age, other medicines, and overall health.
Important: Prescription pain medicines should only be used under the direction of a qualified healthcare professional. Do not buy prescription medicines from unverified online sellers.
Common Prescription Medicines for Back Pain
1. Prescription NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly considered for low back pain. Examples include naproxen, prescription-strength ibuprofen, diclofenac, celecoxib, and etoricoxib.
These medicines can reduce pain and inflammation. However, NSAIDs can cause side effects, including stomach irritation, ulcers or bleeding, kidney problems, and cardiovascular complications in some people.
NICE recommends using oral NSAIDs at the lowest effective dose for the shortest possible period, while considering individual risk factors and whether stomach protection is appropriate.
2. Weak Opioids
For some people with acute low back pain, a doctor may consider a weak opioid such as codeine when an NSAID cannot be used, is not tolerated, or has not worked.
Opioids can cause drowsiness, nausea, constipation, tolerance, and dependence. For this reason, they are generally not recommended for routine or long-term treatment of chronic low back pain.
3. Combination Painkillers
Some prescription or pharmacy medicines combine an opioid with another painkiller. For example, codeine may be combined with another analgesic.
These medicines can sometimes provide short-term relief, but they should be used carefully because opioid-containing medicines can lead to dependence when taken for too long.
4. Medicines for Specific Causes of Back Pain
Back pain can have different causes, including muscle strain, arthritis, a slipped disc, or sciatica. Treatment therefore varies according to the underlying problem.
A doctor may recommend other treatments alongside medication, such as physiotherapy, exercise programmes, psychological support, or specialist treatment when appropriate.
What About Gabapentin and Pregabalin?
Gabapentin and pregabalin are sometimes associated with nerve pain and sciatica. However, current NICE guidance says not to offer gabapentinoids for managing sciatica, because evidence does not show sufficient benefit and there are potential harms.
They should therefore not be started for back pain simply because the pain feels like nerve pain. A healthcare professional should determine whether another diagnosis or treatment is appropriate.
Are Antidepressants Used for Back Pain?
Some antidepressants have been used for chronic pain, but they are not routinely recommended by NICE for managing ordinary low back pain. NICE specifically advises against using SSRIs, SNRIs, or tricyclic antidepressants for low back pain.
This does not mean antidepressants are never appropriate for someone who has pain. A doctor may prescribe them for another diagnosed condition, but they should not be self-used as general back-pain medication.
What Is Usually Recommended Alongside Medication?
Medication is only one part of back-pain management. Staying active and continuing normal activities where possible can help recovery. Exercise, stretching, physiotherapy, and other non-drug treatments may also be recommended.
For persistent pain, healthcare professionals may look for the underlying cause and create a longer-term treatment plan rather than relying on painkillers alone.
When Should You See a Doctor?
You should seek medical advice if your back pain does not improve after a few weeks, interferes with normal activities, becomes progressively worse, or is accompanied by other concerning symptoms.
Seek urgent medical attention if back pain occurs with symptoms such as numbness around the genitals or anus, significant weakness or numbness in both legs, or new problems controlling your bladder or bowels. These can indicate a serious spinal problem requiring immediate assessment.
Frequently Asked Questions
What is the most common prescription medicine for back pain?
NSAIDs are among the medicines considered for low back pain. Depending on the individual’s health and risk factors, a doctor may consider medicines such as naproxen or another appropriate NSAID.
Can doctors prescribe opioids for back pain?
A doctor may consider a weak opioid for acute low back pain in certain circumstances, particularly when an NSAID cannot be used or has not worked. NICE does not recommend opioids for chronic low back pain.
Is paracetamol recommended for back pain?
NICE advises against using paracetamol alone to manage low back pain.
Can I take prescription back-pain medicine without seeing a doctor?
No. Prescription medicines should be used only after an appropriate medical assessment and according to the prescriber’s instructions. This is particularly important with opioids and NSAIDs because they can cause significant side effects and interactions.
Final Thoughts
Prescription medicines can play a role in treating some types of back pain, but there is no single prescription drug that is best for everyone. NSAIDs may be considered for low back pain, while opioids have a much more limited role. Several medicines that were previously used for sciatica or chronic back pain are now discouraged because their benefits may not outweigh their risks.
If you have persistent or severe back pain, speak with a doctor or pharmacist before starting, stopping, or changing medication. A proper diagnosis can help identify the safest and most effective treatment.