What medications are used to treat acute low back pain (LBP)?

Donna Hill Howes, RN
Family Practitioner

Acetaminophen (Tylenol) has been a first-line treatment for acute and chronic low back pain for many years. It is a slightly weaker pain medication than nonsteroidal anti-inflammatory drugs (NSAIDs), but is considered safer. 

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Both acetominophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are analgesics (pain relievers) that are known to provide effective reduction of acute low back pain (LBP). NSAIDs also control inflammation. These medications should be used only as prescribed by a doctor. NSAIDs are associated with possible side effects in certain individuals and risk for such effects increases when used for prolonged periods. The more common side effects include excessive bruising and bleeding, and stomach upset irritation, with kidney and liver problems possible with sustained use.

“Muscle relaxants” are medications that do not actually relax skeletal muscle. However, they do calm or sedate the central nervous system and can be useful to facilitate sleep and secondarily reduce contributing emotional or muscular tension in the setting of severe pain. These medications must be used under the direction of a prescribing doctor.

Narcotics (also called opioids) are strong pain relievers and do reduce the symptoms of acute LBP. Because narcotics are sedating, they can be useful to facilitate sleep during the first few nights of symptoms. Long term use of narcotics is associated with undesirable side effects including physical dependency, sedation, depression, constipation, increased sensitivity of pain-sensitive  fibers and interruption of restorative sleep cycle. Narcotics should only be used as prescribed by and under the direction of a doctor.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.