Medication Alternatives for Back Pain

by lyndal, December 10, 2012
doctor patient pill container 300x199 Medication Alternatives for Back Pain

Doctor and Patient Examining Medication

Back pain can be painful, even if the damage is only mild. For some people, taking a narcotic pain medication is out of the question. Although the risk of dependency is low when narcotics are taken as ordered, some patients may not want to take them. They have side effects, such as sedation and constipation that make them less attractive as a long term back pain management solution.

Fortunately, recent studies have found that certain medications used for other problems are effective against pain, as well. Anti-seizure medications and antidepressants are just two of the alternate therapies that can keep you from taking a narcotic. In some cases, they actually work better than narcotic pain medications because they attack the pain on a different front. Ideally, a combination of narcotics and alternative medications can help you control the worst of your back pain.

Anti-Seizure Medications

Anti-seizure medications are primarily taken by people who suffer from epilepsy, but they have been used in recent years to treat nerve pain and migraine headaches. For those who suffer from peripheral neuropathy, disc herniation, or migraines, this option can be effective for treating the chronic pain that arises from these conditions.

The most common drug prescribed for chronic pain is gabapentin, or Neurotin. Although it does have a side effect of fatigue, it is a powerful drug when used to treat the pains of diabetic peripheral neuropathy and the effects of back conditions, such as sciatica. Another popular prescription in this category is pregabalin, or Lyrica. It is often used for the treatment of chronic pain due to fibromyalgia, and it sometimes has a side effect of mild confusion. Both medications have been prescribed for back pain, and research has shown they are effective.


Antidepressant drugs show promise in scientific research for decreasing chronic pain. The most studied medications are the tricyclic antidepressants, such as amitriptyline and desipramine. These drugs are helpful for a number of conditions, such as migraine headaches, back pain, post-herpetic neuralgia, and other chronic pain conditions. They do not seem to focus on nerve pain as much as the anti-seizure medications, and they are often used for any pain that is chronic.

Other antidepressants used for chronic pain include duloxetine, or Cymbalta, and other selective norepinephrine reuptake inhibitors, and selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, or Prozac. The most effective drugs are the tricyclic antidepressants, but they can cause side effects in some patients. The next most effective are medications such as Cymbalta, and medications such as Prozac are the least effective for chronic pain.

Research has shown that depression and pain often use the same neural pathways in the brain and many of the same neurotransmitters. This is why people with pain often feel depressed, and it explains why antidepressants are effective for pain management. By balancing the chemicals in the brain, it helps the body to overcome chronic pain by altering the delicate brain chemistry that influences depression. Many patients find that both the pain and depression decrease with continued therapy.

Steroid Medication

Steroids, such as prednisone, can sometimes help with chronic pain symptoms. They are used mostly for treating cancer pain, but they can be effective in the treatment of migraine headaches and complex regional pain syndrome. Steroids are most commonly taken for arthritis pain, including arthritis of the facet joints in the spine. Although they do have side effects, such as weight gain and they must be tapered, they do not form dependency like narcotic pain medications do.

Non-Steroidal Anti-Inflammatory Drugs

Non-steroidal anti-inflammatory drugs, or NSAIDs, are most commonly thought of as over the counter pain medications, such as Advil and Aleve. It is true that these medications are NSAIDs, but they are relatively weak NSAIDs when compared to other drugs in the category. For instance, tramadol, or Ultram, is much more effective against chronic or severe pain than an over the counter medication, but it performs essentially the same actions.

These drugs can be used to help with conditions such as arthritis, back pain, and headaches without the dependency caused by narcotics. Some NSAIDs do cause stomach ulcers, and a specific type of this drug called a COX-2 inhibitor, such as Celebrex, has been linked to heart problems. On the whole, though, they are safe and easier to take than a narcotic pain medication for back pain issues.

If you are having back pain and are bewildered by the types of pain medications out there, BASIC Spine can help. We have a pain management doctor on staff that is an expert in these medications and can guide you to the most effective pharmacological combination. In addition, should your back pain continue to cause you trouble, one of our neurosurgeons can help you with possible surgical intervention. Contact us today for a consultation.


    • Debbie Ecksten
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    • December 21, 2012

    Play Again an oral liquid form of injectable hyaluronic acid (HA) taken every day for pain and stiffness. Two physician field studies have shown 87% improvement in joint pain in 14 days. Clinical trial complete data will be available in 30 days. Orthopedic, sports medicine and rheumatologists are recommending and some are dispensing to patients around the country. Dr. Patrick Kersey, St. Vincent Sports Performance, Indianapolis, IN needs help with spine surgery for her patients.

    • Joycelyn Floss
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    • April 26, 2013

    This is a great pain medicatin, would you be involved in doing an interview about just how you administer it? If so e-mail me!

    • mickililley
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    • June 14, 2013

    Wonderful explanation of different medication options, I agree that a mix of treatments is most effective.

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