Because each person responds differently to medication, your doctor may try a variety of drugs and doses. Medications range from over-the-counter acetaminophen, aspirin and other and non-steroidal anti-inflammatory drugs (like naproxen and ibuprofen), to prescription pain medicines such as opioids. Sometimes, in addition to back pain medications, psychiatric medications are also prescribed.

The goal of treating chronic back pain with medication should be to ensure that you’re receiving the maximum benefit and pain reduction at the lowest dose needed. It is also important to take your medication exactly as prescribed and to take care not to overuse or abuse the medication.

Non-Steroidal Anti-Inflammatory Medications (NSAIDs)

This group of drugs includes common over-the-counter medications such as aspirin, ibuprofen, and naproxen, among others. These medications have strong pain-relieving effects and you can generally take them for long periods of time without having to worry about toxicity or that you might become dependent.

NSAIDs are largely effective in reducing the pain associated with spinal arthritis and inflammation among other conditions, and they are frequently used to help reduce pain and inflammation so that you can start rehabilitation efforts, such as physical therapy, which might have otherwise been impossible.

Opioid Therapy

The use of opioid medications to treat chronic back pain is widely rejected for many reasons including potential toxicity to the body, physical dependence, and psychological dependence or addiction. There are, however, some people who have chronic, non-cancer pain, including lower back pain, who may experience relief with opioid therapy without developing toxicity or becoming psychologically dependent.

In any case, opioids should be used only when other non-surgical therapies fail to provide adequate pain relief, and only for short-term relief. You should also be aware of the side effects of this class of drugs and if you decide to try opioid therapy, you are strongly encouraged to have an ongoing dialogue with your doctor. In fact, your doctor will likely insist on monitoring you frequently and require monthly follow-up visits.

Alternatively, targeted drug delivery is a treatment option that delivers pain medication directly to the fluid around the spinal cord. This may result in more effective pain relief with fewer side effects than oral medication, which goes through your circulatory system.

Psychiatric Medications

Pain is characterized as a multidimensional phenomenon, which means it involves many different systems of the body. As of yet, there is little known about the basic mechanisms that produce or maintain the sensory component of pain after tissue damage. There is also little known about the individual person's behavioral response to pain. This is particularly true for chronic pain.

Psychiatric medications are not for everyone with chronic back pain. Your doctor will need to have a clear understanding of the root of your pain in order to decide whether the pain will be responsive to the medication. In addition, any psychiatric disorder that may be causing the pain, such as depression, should be diagnosed accurately so that the appropriate target symptoms can be identified for treatment.

Keep in mind, psychiatric medications are an additional element and not a substitute for a comprehensive treatment plan for chronic back pain. As part of your treatment plan, your doctor should include education, physical therapy, behavioral assessment, and evaluation of your family and occupational roles. Lastly, constant and attentive follow-up is important in order to monitor your progress, pinpoint recurring symptoms, and to discuss whether or not the specific treatments are working.