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Medications for Low Back Pain and Sciatica

Living With Low Back Pain and Sciatica
Living With 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 choice of medication depends on the nature and duration of the pain.

The medications are listed by their generic name.

Prescription Medications

Nonsteroidal anti-inflammatory drugs (NSAIDS)

  • Naproxen
  • Ibuprofen
  • Diclofenac
  • Celecoxib
  • Meloxicam

Opioids

  • Codeine
  • Oxycodone

Antidepressants

  • Fluoxetine
  • Duloxetine
  • Amitriptyline

Muscle relaxants

  • Cyclobenzaprine
  • Diazepam

Over-the-Counter Medications

Nonsteroidal anti-inflammatory drugs (NSAIDS)

  • Naproxen
  • Ibuprofen

Pain Relievers

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

Prescription Medications

 

Nonsteroidal Anti-Inflammatory Drugs (NSAIDS)

Common names include:

  • Naproxen
  • Ibuprofen
  • Diclofenac
  • Celecoxib
  • Meloxicam

These drugs work to control inflammation, which produces pain. They are used for acute and chronic low back pain, and sciatica.

Some prescription NSAIDs are higher doses of the same NSAIDs that are available without a prescription. Some NSAIDs come in topical forms.

Possible side effects include:

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

Some prescription NSAIDs (such as celecoxib and 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.

 

Opioids

Common names include:

  • Codeine
  • Oxycodone

Prescription opioids may be prescribed short-term for severe acute low back pain and sciatica. Slow-release forms may be used in chronic low back pain.

Possible side effects include:

  • Drowsiness
  • Constipation
  • Decreased breathing

Longer use of opioids has a high risk of abuse or addiction

 

Antidepressants

Common names include:

  • Fluoxetine
  • Duloxetine
  • Amitriptyline

Antidepressants may reduce pain in people with chronic low back pain.

Possible side effects include:

  • Risk of severe mood and behavior changes
  • Stomach irritation
  • Nausea
  • Diarrhea
  • Lightheadedness
  • Dry mouth
  • Constipation
  • Difficulty urinating
 

Muscle Relaxants

Common names include:

  • Cyclobenzaprine
  • Diazepam

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

Possible side effects include:

  • Drowsiness
  • Lightheadedness
  • Addiction
  • Allergic side-effects

Over-the-Counter Medications

 

Nonsteroidal Anti-Inflammatory Drugs (NSAIDS)

Common names include:

  • Naproxen
  • Ibuprofen

These drugs work to control inflammation, which produces pain. They are used for acute and chronic low back pain, and sciatica.

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 high blood pressure.
 

Acetaminophen

Acetaminophen relieves pain through different mechanisms than NSAIDs. It is used for acute and chronic low back pain, and sciatica.

  • 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 does not 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

If you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Do not share your prescription medication.
  • Medications can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medication, including over-the-counter products and supplements.
  • Plan ahead for refills as needed.
REFERENCES:

Acute low back pain. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114958/Acute-low-back-pain. Updated October 25, 2017. Accessed December 27, 2017.

Chronic low back pain. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116935/Chronic-low-back-pain. Updated June 30, 2017. Accessed December 27, 2017.

Low back pain. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/low-back-pain. Updated December 2013. Accessed December 27, 2017.

Sciatica. Cleveland clinic website. Available at: https://my.clevelandclinic.org/health/diseases/12792-sciatica. Updated July 22, 2014. Accessed December 27, 2017.

Sciatica. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115166/Sciatica. Updated May 8, 2017. Accessed December 27, 2017.

9/2/2009 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T116935/Chronic-low-back-pain. Urquhart D, Hoving JL, Assendelft WW, Roland M, van Tulder MW. Antidepressants for non-specific low back pain. Cochrane Database Syst Rev. 2009;(3):CD001703.

2/18/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T113820/Antidepressant-medication-overview. Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.

5/23/2017 DynaMed Plus Systematic Literature Surveillancehttps://www.dynamed.com/topics/dmp~AN~T115166/Sciatica: National Guideline Centre. Low back pain and sciatica in over 16s: assessment and management. London (UK): National Institute for Health and Care Excellence (NICE); 2016 Nov.

Last reviewed November 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP