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Medications for Low Back Pain and Sciatica

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Medications are used to control symptoms of low back pain and sciatica. The medications are listed by their generic name.

Prescription Medications

Nonsteroidal anti-inflammatory drugs (NSAIDS)

  • Naproxen sodium
  • Ibuprofen
  • Diclofenac sodium
  • Celecoxib
  • Meloxicam

Analgesics (pain medication)

  • Codeine
  • Oxycodone

Antidepressants

  • Fluoxetine
  • Duloxetine
  • Amitriptyline

Muscle relaxants

  • Cyclobenzaprine
  • Diazepam

Over-the-Counter Medications

Nonsteroidal anti-inflammatory drugs (NSAIDS)

  • Naproxen sodium
  • Ibuprofen

Analgesics (pain medication)

  • Acetaminophen
  • Aspirin
  • Topical analgesics, such as creams, lotions, ointments, and patches

Prescription Medications

Nonsteroidal Anti-Inflammatory Drugs (NSAIDS)

Common names include:

  • Naproxen sodium
  • Ibuprofen
  • Diclofenac sodium
  • Celecoxib
  • Meloxicam

These drugs work to control inflammation, which produces pain. Some prescription NSAIDs are higher doses of the same NSAIDs that are available without a prescription.

Possible side effects include:

  • Gastrointestinal bleeding
  • Stomach upset
  • Fluid retention
  • Liver damage

Some prescription NSAIDs (such as, celecoxib, meloxicam) have been associated with an increased risk of heart attack and stroke. Other studies show that some NSAIDs may cause complications in patients recovering from stroke, heart attacks, or open heart surgery. NSAIDs can also interfere with the actions of other drugs. Be certain your physician is aware of all drugs you take, including herbs and supplements even if you only take these occasionally.

Analgesics

Common names include:

  • Codeine
  • Oxycodone

Prescription pain pills may be prescribed short-term for severe pain.

Possible side effects include:

  • Drowsiness
  • Constipation
  • Decreased breathing
Antidepressants

Common names include:

  • Fluoxetine
  • Duloxetine
  • Amitriptyline

Antidepressants may also be prescribed for chronic low back pain.

Possible side effects include:

  • Blurred vision
  • Weight gain
  • Dry mouth
  • Lightheadedness when standing

Do not stop taking these drugs without checking with your doctor.

Muscle Relaxants

Common names include:

  • Cyclobenzaprine
  • Diazepam

Muscle relaxants help calm muscle spasms. They may be ordered for short-term pain relief.

Possible side effects include:

  • Drowsiness
  • Lightheadedness

Over-the-Counter Medications

Nonsteroidal Anti-Inflammatory Drugs (NSAIDS)

Common names include:

  • Naproxen sodium
  • Ibuprofen

These drugs work to control inflammation, which produces pain.

Possible side effects include:

  • Gastrointestinal bleeding
  • Stomach upset
  • Liver damage
  • Fluid retention
  • Interaction with other drugs, including angiotensin-converting enzyme (ACE) inhibitors, blood thinners, and drugs to treat hypertension. Check with your physician to be certain that NSAIDs will not interact with other drugs you might be taking.
Acetaminophen

Acetaminophen relieves pain through different biological mechanisms. It is not an NSAID. It can cause or exacerbate liver problems if recommended doses are exceeded. Do not drink alcohol while taking this drug. Do not take more than the recommended dose. Acetaminophen is unlikely to cause side effects associated with other pain medications such as gastrointestinal upset, fluid retention, and constipation.

When to Contact Your Doctor

Contact your doctor if you experience these symptoms:

  • Pain that doesn't improve, or worsens, with rest
  • Pain that is severe or that has gotten dramatically worse
  • Progressive weakness in a leg or foot
  • Difficulty walking, standing, or moving
  • Numbness in the genital or rectal area
  • Loss of bowel or bladder control
  • Burning or difficulty with urination
  • Fever, unexplained weight loss, or other signs of illness

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:

  • Take your medication as directed. Do not change the amount or the schedule.
  • Do not stop taking prescription medication without talking to your doctor.
  • Do not share prescription medication.
  • Ask what results and side effects to expect. Report them to your doctor.
  • Some medications can be dangerous when mixed. Talk to a doctor or pharmacist if your child is taking more than one medication. This includes over-the-counter medication and herb or dietary supplements.
  • Plan ahead for refills so you don’t run out.

Revision Information

  • Acute low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 25, 2015. Accessed December 16, 2015.

  • Chronic low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 30, 2015. Accessed December 16, 2015.

  • Low back pain. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00311. Updated December 2013. Accessed December 15, 2015.

  • Oltean H, Robbins C, van Tulder MW, et al. Herbal medicine for low back pain. Cochrane Database Syst Rev. 2014;(12):CD004504

  • Pain. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/chronic%5Fpain/detail%5Fchronic%5Fpain.htm#3084%5F16. Updated November 3, 2015. Accessed December 16, 2015.

  • Santos J, Alarcao J, Fareleira F, et al. Tapentadol for chronic musculoskeletal pain in adults.

  • Sciatica. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 19, 2015. Accessed December 16, 2015.

  • 9/2/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed. Urquhart D, Hoving J, et al. Antidepressants for non-specific low back pain. Cochrane Database Syst Rev. 2009;(3):CD001703.

  • 11/12/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed. US Food and Drug Administration. FDA clears Cymbalta to treat chronic musculoskeletal pain. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm232708.htm. Published November 4, 2010. Accessed November 12, 2010.

  • 2/18/2011 DynaMed's Systematic Literature Surveillance http://www.dynamicmedical.com/what.php. Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.