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Analgesics for Back Pain and Neck Pain

Are Painkillers a Treatment Option for You?

Peer Reviewed

Simply put, analgesics are pain-relieving drugs. In fact, the word "analgesic" is derived from the Greek words "an" and "algesis," meaning without pain. If you've ever suffered from a back and/or neck condition, you've likely taken an analgesic to reduce your symptoms. You might even know them better as painkillers. Common analgesics are acetaminophen (over-the-counter) and opioids (prescription).

Analgesics are a large class of medications that are available in oral or topical form. Some analgesics can be purchased over-the-counter, while others can be used only with a prescription. Some relieve pain, while others reduce pain and  inflammation.

To help you best understand this group of medications, this article has 2 main sections: over-the-counter analgesics and prescription analgesics.

Over-the-counter Analgesics
Acetaminophen (such as Tylenol) is one of the most commonly used medications for back pain, and so it's no surprise that it's the most popular over-the-counter analgesic. It's also often found in combination with narcotic analgesics such as Percocet and Lortab.

Acetaminophen's purpose is solely to relieve pain. That is, it doesn't reduce inflammation.

Other examples of over-the-counter analgesics are listed below. All are non-steroidal anti-inflammatory drugs (NSAIDs); that is, these analgesics not only reduce pain but also inflammation:

  • Aspirin
  • Ibuprofen (such as Advil or Motrin)
  • Naproxen (such as Aleve)

Topical applications of analgesics, such as capsaicin cream (Capzasin-P and Zostrix brands) and salicylates (brands such as Sportscreme and Aspercreme) are an alternative to oral analgesics. These creams and balms are commonly used to relieve joint pain on the legs and arms, but some patients find that they reduce back pain as well.

To learn more, read our article about how topical drugs reduce back and neck pain.

Over-the-counter analgesics are most effective at the earliest signs of acute back pain. If you wait until your pain has progressed to the point where over-the-counter analgesics cannot manage it, then you may need to explore stronger treatment options, such as prescription analgesics.

Prescription Analgesics
Your doctor may prescribe an analgesic for a variety of reasons. If you recently had spine surgery, these medications are often potent enough to control the acute pain after the operation. Or perhaps your back pain is so intense that over-the-counter analgesics are no longer effective at managing your symptoms. Whatever the reason, what's most important is that you precisely follow your doctor's instructions while taking these medications, as they do carry potentially serious side effects. 

The 2 main types of prescription analgesics described in this article are COX-2 inhibitors and opioids.

COX-2 Inhibitors
COX-2 inhibitors are a newer class of prescription NSAIDs that reduce pain and inflammation but with a lower risk of gastrointestinal side effects associated with traditional NSAIDs.

Celecoxib (Celebrex) is an example of COX-2 inhibitors.

Side effects of COX-2 inhibitors include an increased risk of cardiovascular problems, such as heart attack or blood clots. And while COX-2 inhibitors pose a lower risk of stomach problems than traditional NSAIDs, there is still a risk. So if you have any gastrointestinal condition, make sure to talk to your doctor about it before taking these medications.

Opioids
Opioids are extremely potent analgesics—and they should only be taken if you have severe chronic pain. Opioids are also called narcotics, which might make you uncertain about using them. Though the word "narcotic" carries some negative connotations, these types of drugs are safe and effective when used correctly and under a doctor's supervision.

Opioids work by essentially decreasing your perception of, and therefore your reaction to, pain.

There are many types of narcotic analgesics. Morphine (such as MS Contin) is one of the most well-known narcotics, but other opioids include:

  • codeine
  • hydrocodone (Vicodin)
  • oxycodone (OxyContin)
  • meperidine (Demerol) " tramadol (Ultram)
  • hydromorphone (Dilaudid)

The main concern surrounding opioids is the risk of addiction. However, these medications are safe and effective when used correctly and under the careful supervision of your doctor.

Besides the risk of becoming dependant on narcotic painkillers, other side effects include:

  • drowsiness
  • constipation
  • nausea

To learn more, read our article about how opioids treat back and neck pain .

Analgesics—both over-the-counter and prescription—are a commonly used defense against back and neck pain. When used correctly, they are safe and effective at managing back pain and neck pain. As always, talk to your doctor about any questions and/or concerns you have about your treatment plan.

Updated on: 11/13/12
Jason M. Highsmith, MD
This article was reviewed by Jason M. Highsmith,MD.
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