Medicines and pain relief for lower back pain

Expert review by:
Anish Jain , Pharmacy Manager, Bupa

Key points

  • Medicines can help with the symptoms of lower back pain, but they won’t treat the cause.
  • Treatment options for back pain include non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants. Heat or ice may also help.
  • Most short-term back pain improves within four to six weeks. But if it doesn’t improve after a few weeks, or is severe, you should see a GP.

There are medicines that you can take for lower back pain. While these can help with the symptoms of lower back pain, they won’t treat the cause of the pain. This is why it’s important to keep active and mobile, too. Medicines will help you to do this.

What’s the best painkiller for lower back pain?

The medicines your doctor may recommend for lower back pain will depend on:

  • what’s causing the pain
  • how severe the pain is
  • whether that medicine is suitable for you

All medicines come with the risk of side-effects. These are the temporary unwanted effects of a medicine. Your doctor will consider side-effects when prescribing medicines.

When should I see a doctor for back pain?

You should see a GP if your back pain is severe or doesn’t improve after a few weeks. Or if you have any ‘red flag’ symptoms, such as numbness or back pain that starts after a fall or an accident. Most people with short-term (acute) back pain will recover within four to six weeks.

Your GP may refer you to a specialist pain service or clinic for more specialist help if your pain is:

  • very severe
  • getting worse
  • seriously affecting your quality of life

They may also refer you to a physiotherapist.

Pain relief for lower back pain

NSAID tablets

If you have lower back pain, your GP may suggest you take an over-the-counter NSAID (non-steroidal anti-inflammatory drug), such as ibuprofen. If this doesn’t help, your doctor may prescribe a different NSAID or another type of painkiller that may work better for you.

They’ll prescribe the lowest dose to take for the shortest period of time. NSAIDs can cause stomach problems, such as indigestion, which causes pain and discomfort, bloating, and nausea. Your doctor may also prescribe another medicine to protect your stomach while you take the NSAID for lower back pain. It’s best to take NSAIDs with a meal to help protect your stomach.

NSAID gel

Another option to ease lower back pain is an NSAID cream or gel that you put on the affected area. This is less likely to cause any stomach problems. But creams and gels only work where you apply them. For example, although an ibuprofen tablet might help pain in both your back and knee, you would need to put cream on both places to feel the effects in both areas.

Opioids

If NSAIDs don’t work, or you can’t take them, your doctor may prescribe a medicine called an opioid for acute lower back pain. You may be prescribed weak opioids (such as codeine) for moderate pain. It’s unclear whether opioids can help with long-term pain, and side-effects are common. For example, codeine can cause constipation. Your doctor will take this into consideration and explain the risks and side-effects to you.

Is paracetamol enough on its own?

Paracetamol alone is not very effective at treating lower back pain. But it might help if you can’t take NSAIDs, or if you take it in combination with NSAIDs.

Medicines for muscle spasm

Muscle relaxants

If you’re having muscle spasms, your doctor may prescribe a muscle relaxant medicine, such as diazepam, to relax your muscles.

Diazepam is a type of benzodiazepine. It’s only prescribed for a short time. This is because you can become dependent on benzodiazepines if you take them for a long time, and you may develop withdrawal symptoms.

Withdrawal symptoms include:

The main side-effects of taking diazepam are:

  • feeling drowsy
  • being less able to concentrate

It’s very important to follow your doctor’s advice about driving, or whether you need to stop driving while you take diazepam. Even if you only take diazepam at night, it can affect your ability to drive the following day.

Heat and ice for back pain

A hot water bottle or heat pad may help ease muscle spasms and lower back pain. Make sure you protect your skin – don’t put heat pads directly onto your skin and make sure hot water bottles are fully sealed. You can buy pads that you put over your clothing on the area that hurts. These are available from pharmacies and last for several hours.

Ice packs may also be helpful, especially in the first few days of any injury. Make sure you wrap the ice pack in a towel to protect your skin. You can apply the pack to the area that hurts for 15 to 20 minutes at a time every 2 to 3 hours.

Pain relief for lower back pain with sciatica

You’ll have a follow-up appointment with your doctor to see how well your medicine is working and to talk about any problems or side-effects.

Sciatica is when you have pain in your lower back, buttocks, and down one or both legs. If you have severe sciatica and the above treatments haven’t controlled the pain, your doctor may suggest you have an epidural injection. Epidural injections contain a local anaesthetic and steroid to relieve pain and reduce inflammation, and this will be injected in your back.

Physiotherapy services

Our evidence-based physiotherapy services are designed to address a wide range of musculoskeletal conditions, promote recovery, and enhance overall quality of life. Our physiotherapists are specialised in treating orthopaedic, rheumatological, musculoskeletal conditions and sports-related injury by using tools including education and advice, pain management strategies, exercise therapy and manual therapy techniques.

To book or to make an enquiry, call us on 0345 850 8399

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