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Best medicines for back pain: a comprehensive guide

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 2 minutes read

Back pain is a common ailment that can sometimes require medication for effective relief. In this detailed article, we will explore different types of back pain and discuss the most suitable medicines for each case. It is crucial to understand that the strongest treatment is not always the best option, and milder approaches can be equally effective, such as stretching exercises.

Doctor’s advice

Targeting mild pain: tablets to try first

If non-drug options haven't provided sufficient relief, pain relief tablets can be considered. Acetaminophen is a safe and sensible initial choice, with few risks or side effects when used as directed. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can also be effective, especially when inflammation contributes to the pain.

Targeting moderate pain: next steps

When acetaminophen or ibuprofen alone are not enough, combining them can provide more comprehensive pain relief. If further relief is still needed, consultation with a doctor is recommended. They can prescribe stronger pain medications. These should only be used for short-term relief.

Targeting severe pain: opioids

For severe back pain unresponsive to milder options, opioids may be necessary. Opioids range from codeine to tramadol and different forms of morphine. These medications can be effective but can also cause side effects such as constipation, drowsiness, and dizziness. Individual susceptibility to these effects may vary.

Targeting more severe pain: neuropathic painkillers

Sometimes back pain will be due to pinched nerves, which can cause tingling or burning sensations, which is where neuropathic painkillers work. They specifically target nerve pain. Only available on prescription, they work by blocking the neurotransmitter that activates the pain pathway. They are very effective. However, some can cause side effects, such as drowsiness, dizziness and feeling sluggish. Some newer versions have fewer side effects and are more tolerated but are usually only given if the others have failed.

These neuropathic painkillers have a cumulative effect, meaning you need to take them regularly for a week or two until you see results and build up the dose gradually until effective. Higher doses often bring more side effects, so this may be a play-off against effective pain relief. And you should be cautious if you feel drowsy and you drive or operate heavy machinery.


Choosing the right medicine for back pain depends on the severity and nature of the pain. It is essential to start with milder options, such as acetaminophen and ibuprofen, and progress to stronger medications if necessary. Always consult your doctor or pharmacist for guidance and to ensure safe and appropriate use of these medicines.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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