Analgesics for Back Pain and Neck Pain

Over-the-counter and prescription painkillers—are either a treatment option for your spine-related pain?

Simply put, analgesics are pain-relieving drugs—and you may know them better as painkillers. 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.

  • Analgesics are available over-the-counter (OTC) and by prescription.
  • Certain prescription analgesics include the potent form of an OTC drug.
  • Some analgesics are available in oral or topical form.
  • Certain analgesics relieve pain, while others reduce inflammation and pain.

Medication packet in jeans pocket

Over-the-counter (OTC) Analgesics

Acetaminophen, Non-steroidal anti-inflammatory drugs, topical analgesics

OTC analgesics may be more effective when taken at the earliest sign of acute back or neck pain. Muscle sprains/strains and whiplash are common types of injury known to cause severe short term pain.

Be sure to follow the OTC’s dosage recommendations and precautions. If the OTC drug does not adequately manage the pain, or pain and other symptoms worsen, see your doctor or healthcare provider. You may need a prescription analgesic to help manage your pain, and/or additional medical care.

Acetaminophen
Acetaminophen (such as Tylenol) is one of the most common medications taken for back and neck pain, and so it's no surprise that it's the most popular OTC analgesic.

  • Acetaminophen's purpose is solely to relieve pain. So, it won’t reduce inflammation.

Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs work to reduce inflammation and pain. Types of over-the-counter NSAIDs include:

  • Aspirin
  • Ibuprofen (eg, Advil, Motrin)
  • Naproxen (eg, Aleve)

Topical analgesics
Topical applications of analgesics, such as capsaicin cream (Capzasin-P and Zostrix brands) and salicylates* (brands such as Sportscreme and Aspercreme), are alternatives to oral analgesics. These creams and balms are commonly applied to skin to help relieve joint-related pain, and some patients find a topical help reduce back pain too.

*Salicylates are plant-based chemicals that work to decrease the body's production of prostaglandins that cause inflammation and pain.

Prescription Analgesics

Your doctor may prescribe an analgesic as part of your treatment plan to help manage acute (short term) or chronic pain. It is very important that you precisely follow your prescribing doctor's instructions as to how much (ie, dose) and when to take your medication. Keep in mind that any drug has potential side effects, including the risk for adverse interaction when taken with other medications. Be sure to talk with your doctor about your potential risks, and keep him/her informed about medications taken to treat other medical problems (eg, blood pressure, diabetes).

COX-2 inhibitors
Cyclo-oxygenase-2 (COX-2) inhibitors are a type of prescription NSAID formulated to target an enzyme that triggers inflammation. Inflammation is not only a symptom, but a cause of pain related to many different spinal disorders. Unlike other types of NSAIDs, COX-2 inhibitors have a lower risk of causing or contributing to gastrointestinal problems, such as peptic ulcer. However, there are other potential side effects and risks associated with COX-2 inhibitors.

Currently, celecoxib (brand, Celebrex) is the only COX-2 inhibitor currently available in the United States. You can learn more about this drug in this Celecoxib Patient Guide.

Potential 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 classic NSAIDs, there is still a risk. So, if you have a gastrointestinal condition, be sure to talk to your doctor about it before taking these medications.

Opioids
Opioids are extremely potent analgesics and may not be the first type pain relieving drug your doctor prescribes. Opioids may be an appropriate choice to help reduce moderate to severe back or neck pain. These drugs essentially work by decreasing your perception of, and therefore your reaction to, pain. An opioid may be prescribed for short term use following spine surgery, although there are different situations where use is appropriate.

When an opioid is recommended, your doctor prescribes the lowest strength (ie, dose) to manage your pain condition. 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.

There are many types of opioids. Morphine (eg, MS Contin) is one of the most well-known narcotics. Other opioids include:

  • Codeine (usually generic)
  • Hydrocodone (Vicodin)
  • Oxycodone (OxyContin)
  • Meperidine (Demerol)
  • Tramadol (Ultram)
  • Hydromorphone (Dilaudid)

Opioids have the potential to elevate your risk for addiction and abuse. Unfortunately, misuse of these medications has resulted in death. Physicians are under greater scrutiny by government and regulatory agencies about how they prescribe opioids. However, if you are prescribed an opioid, know that the medication may be safe and effective if you use it exactly as your doctor instructs.

Side effects may include:

Analgesics: An Ally Against Back Pain

Analgesics—both OTC and prescription—are a commonly used defense against back and neck pain. When used correctly with your doctor’s knowledge, they can be safe and effective at managing spine-related pain. If you experience new symptoms and/or your pain changes, promptly take action to talk with your doctor.

Updated on: 07/25/17
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