Medicines and pain relief for lower back pain
Your health expert: Madeeha Waheed, Oncology Pharmacist at Bupa, Core Contact Clinical Services
Content editor review by Rachael Mayfield-Blake, June 2023
Next review due June 2026
There are medicines that you can take for lower back pain. While these can help with the symptoms of lower back pain, such as pain, they won’t treat the cause. This is why it’s really important to keep active and mobile too. Medicines will help you to do this.
About medicines and pain relief for lower back pain
The medicines and pain relief your doctor may offer for lower back pain will depend on what’s causing it, how severe it is, and whether a medicine is suitable for you. Most people with short-term (acute) back pain will recover fairly quickly, 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
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. NSAIDs can also potentially cause stomach ulcers. So, your doctor may also prescribe another medicine to protect your stomach while you take the NSAID for lower back pain. And 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 far 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
Your doctor may also prescribe a medicine called an opioid for lower back pain. Weak opioids (such as codeine) may be given for moderate pain. For severe and persistent pain, you may need stronger opioids, such as morphine.
You might have this with or without paracetamol. Paracetamol works well for lower back pain when combined with other medicines.
There’s a risk of becoming dependent on codeine, and it can also cause constipation. Your doctor will take this into consideration and explain the risks and side-effects to you.
Medicines for muscle spasm
If you’re having muscle spasms, your doctor may prescribe a muscle relaxant medicine, such as diazepam, to relax your muscles. Diazepam is only prescribed for a short time because there can be problems with withdrawal symptoms and you can become dependent on it if you take diazepam for a long time. Withdrawal symptoms include:
- anxiety
- difficulty sleeping
- confusion
- loss of appetite
- sweating
- heart palpitations
All medicines come with the risk of side-effects; these are the temporary unwanted effects of a medicine. 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
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.
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.
Prevention of upper back pain
The following tips may help to prevent you from developing upper back pain.
- Properly support your back when you’re sitting.
- If you work at a desk, arrange an assessment of your set up to make sure your equipment is set up correctly.
- If you wake up with back pain, a more supportive mattress that adjusts to your back and supports it properly may help.
- Take regular breaks from sitting for long periods of time and from doing repetitive tasks.
- Have good posture and when you lift objects, do this safely and correctly.
- Exercise regularly.
- Stop doing any activity that you know causes your back pain.
- Stop smoking – it can damage the discs between your vertebrae that act as shock absorbers.
- If you’re overweight, losing weight may help to reduce the risk of back pain.
- Change activities that cause you pain so you can still enjoy them – slow down, do less, get help, for example.
The best medicine for lower back pain will depend on what’s causing it, how severe it is, and whether a medicine is suitable for you. Your doctor may offer you tablets or creams.
For more information, see the sections: about medicines and pain relief for lower back pain.
If you’re worried that your back pain is serious, it’s best to see a GP or physiotherapist. Most people with short-term (acute) back pain will recover fairly quickly, within four to six weeks. But your GP may refer you to a specialist pain service or clinic for more specialist help if your pain is very severe, getting worse or is seriously affecting your quality of life.
For more information, see the sections: about medicines and pain relief for lower back pain.
It’s difficult to say as it can vary depending on what’s caused it. But about 9 in 10 people with lower back pain feel much better within 4 to 6 weeks, although you may continue to have some pain. It’s possible that your pain can come back too. If you still have lower back pain after 4 to 6 weeks and medicines haven’t helped, talk to a GP or physiotherapist.
For more information, see the sections: about medicines and pain relief for lower back pain.
You can often take over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen for lower back pain (but check with a pharmacist). If this doesn’t help, your GP may prescribe a different NSAID or another type of painkiller that may work better for you. There are also NSAID creams or gels that you put on the affected area, and muscle relaxant medicines that can help if you’re having muscle spasm.
For more information, see the sections: pain relief for lower back pain and medicines for muscle spasm.
Did our Medicines and pain relief for lower back pain information help you?
We’d love to hear what you think.∧ Our short survey takes just a few minutes to complete and helps us to keep improving our health information.
∧The health information on this page is intended for informational purposes only. We do not endorse any commercial products, or include Bupa's fees for treatments and/or services. For more information about prices visit: www.bupa.co.uk/health/payg
This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals and deemed accurate on the date of review. Photos are only for illustrative purposes and do not reflect every presentation of a condition.
Any information about a treatment or procedure is generic, and does not necessarily describe that treatment or procedure as delivered by Bupa or its associated providers.
The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page.
- Musculoskeletal lower back pain. Management approach. BMJ Best Practice. bestpractice.bmj.com, last reviewed 17 March 2023
- Low back pain and sciatica in over 16s: assessment and management. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, last updated 11 December 2020
- Low back pain and sciatica. Patient. patient.info/doctor, last edited 16 October 2020
- Musculoskeletal lower back pain. BMJ Best Practice. bestpractice.bmj.com, last reviewed 17 March 2023
- Analgesia – mild-to-moderate pain. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised November 2021
- Low back pain and sciatica. NICE British National Formulary. bnf.nice.org.uk, last updated 29 March 2023
- Ibuprofen 200 mg tablets. emc. www.medicines.org.uk, accessed 18 April 2023
- NSAIDS – prescribing issues. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised April 2020
- Personal communication, Madeeha Waheed, Oncology Pharmacist at Bupa, Core Contact Clinical Services, 22 June 2023
- Ibugel. emc. www.medicines.org.uk, accessed 18 April 2023
- Management of chronic pain. Scottish Intercollegiate Guidelines Network (SIGN). www.sign.ac.uk, revised August 2019
- Analgesics. NICE British National Formulary. bnf.nice.org.uk, last updated 31 May 2023
- Spinal stenosis. BMJ Best Practice. bestpractice.bmj.com, last reviewed 28 February 2023
- Diazepam. NICE British National Formulary. bnf.nice.org.uk, last updated 29 March 2023
- Hypnotics and anxiolytics. NICE British National Formulary. bnf.nice.org.uk, last updated 29 March 2023
- Sprains and strains. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised September 2020
- Sciatica (lumbar radiculopathy). NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised February 2022
