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The Best Medicine For Lower Back Pain Relief

5/20/20255 min read

Can Medicine Really Fix Your Back Pain?

When lower back pain strikes, most people instinctively reach for medication, and understandably so. The pain can be sharp, persistent, and sometimes disabling. But here’s what many don’t realise:

Painkillers aren’t designed to fix the problem. Rather, they’re designed to give you a window of opportunity to solve it.

In other words, they can help you function and move while you address the root cause of your pain. If you rely on them alone without an expert diagnosis or a proper treatment plan, you’re likely to end up masking the symptoms rather than resolving the issue.

That’s why it’s so important to understand the different classes of medications available, and how they fit into a broader strategy for long-term pain relief. Let’s explore five common types of medicines used by patients with lower back pain, when they’re appropriate, and what to watch out for.

Disclaimer: As with all our blogs and social media posts, this must not be taken as medical advice. I am not a prescribing physio. Please read our full disclaimer here.

🎥 Watch the full video:

5 Classes Of Medicines Commonly Used By Patients With Lower Back Pain

1. Non-Opioid Analgesics (e.g. Paracetamol)

Often the first thing people reach for when back pain starts, paracetamol is widely available and considered relatively safe when taken correctly, though it can have some rare side effects such as thrombocytopenia (low platelet count). Aspirin is another example of a non-opioid, though it can be used to prevent cardiovascular disease when given at a certain dose and can therefore interact with other meds.

✅ Used for: Mild to moderate, general musculoskeletal pain
⚠️ Caution: Aspirin is used as an anti-coagulant and therefore can interact with other meds such as warfarin. Read more about non opioid analgesics here.

2. NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

Medications like Ibuprofen and Naproxen can help reduce inflammation. This is especially useful when your back pain is linked to irritation or swelling around a joint or disc. Some common signs of inflammation are heat (hot to the touch), redness, swelling and of course, pain. If the nature of your pain is inflammatory (your physio should be able to tell you), you may also notice that your pain gets better with movement. Some NSAIDs may be in gel form. As explained in the video above, the difference tends to be that the effect is local, rather than systemic.

✅ Used for: Moderate pain with inflammation (e.g. after an injury or flare-up of spinal arthritis)
⚠️ Caution: Best taken short-term; may aggravate stomach issues.
🩺 Side effects: Stomach irritation, ulcers, kidney stress.
📚 Read more about NSAIDS here.

3. Opioid Analgesics (e.g. Codeine, Morphine, Tramadol)

Opioids may be prescribed for short-term relief during severe pain episodes, but they come with serious caveats. At this stage, you can no longer get these over the counter. You would need a medical prescription from your doctor or prescribing physiotherapist. I am not one, remember!

✅ Used for: Severe acute pain that’s not responsive to milder meds. It would be worrying if this is the first drug class you are prescribed when you first complain of back pain to your doctor. In my experience, it's never happened before trying other meds or physiotherapy in combination with other medication.
⚠️ Caution: High risk of dependence and withdrawal symptoms. These can be very serious.
🩺 Side effects: Constipation, dizziness, reduced alertness, addiction. Read more about opioids here.
💬 In most cases, opioids should only be used briefly while initiating more sustainable interventions, such as physiotherapy.

4. Muscle Relaxants (e.g. Diazepam)

When muscle spasms are part of your pain presenting picture, a short course of muscle relaxants such as Diazepam might be helpful. But again, short-term is key. As I reiterate in the video a few times, it's important to understand your diagnosis at any point, but even more so at the point where you begin taking medications such as Diazepam or opioids mentioned above.

I encourage you to ask your doctor / prescriber questions such as "what is my diagnosis?", "How long do you expect me to be on these meds for?". "What is the plan to wean me off and when?" - and most importantly, if you have not been referred to see a physio, "What is the solution to the underlying issue / diagnosis?"

✅ Used for: Painful muscle spasms linked to poor posture or guarding behaviour
⚠️ Caution: Not a long-term solution. Read more about Diazepam here.
🩺 Side effects: Anxiety, sedation, ataxia, dizziness, drowsiness, dependence etc.

💡 Note: If you’ve been prescribed muscle relaxants and your pain returns as soon as you stop them, the underlying mechanical issue may be untreated. A thorough physio assessment can help pinpoint the cause.

5. Neuropathic (Nerve) Pain Medications (e.g. Gabapentin, Pregabalin)

These medications are used when the pain feels sharp, electric, or burning - often due to nerve compression or irritation. We tend to see Pregabalin and Gabapentin prescribed by doctors, though with a lot of careful consideration.

✅ Used for: Sciatica, nerve-related back pain
⚠️ Caution: Must be reviewed regularly due to serious side effects
🩺 Side effects: Drowsiness, memory issues, mood changes, weight gain
📚 Read more about the pharmacological management of neuropathic pain in adults here.

💬 These medications are often used in cases of sciatica or spinal stenosis, where nerve roots are being compressed. Still, medication alone won’t relieve the compression—it can only reduce the symptoms temporarily.

6. Steroid Injections

Whilst not a tablet, spinal steroid injections are typically used when other treatments such as medications haven’t worked and the pain is severe or disabling. They aim to reduce inflammation around nerve roots.

✅ Used for: Sciatica, spinal stenosis, disc herniations
⚠️ Caution: Not a long-term fix. It may work for some and not others. When it does work, the effect wears off and the pain returns, if not dealt with.
🩺 Side effects: Short-term relief only, with potential risks if overused.
💬 Injections are best used in combination with physiotherapy, to maximise the effects of reduced inflammation while addressing movement issues.

💡 The Most Effective Painkiller? Movement.

This may surprise you: the most powerful painkiller your body has is movement. Yes, even when you’re in pain.

At The London Physio, we see it often—clients who have avoided movement for weeks (or even months) because it hurts. But what often causes the pain during movement is not the movement itself—it's the stiffness, weakness, and faulty movement patterns that come from not moving enough.

“Motion is lotion”—but only when you’re doing the right kind of movement.

This is where a physiotherapist plays a vital role.

🧠 Why You Need a Physiotherapist – Not Just Pills

Medications can ease your symptoms, but they won’t tell you why your back hurts or what to do to fix it. A Chartered physiotherapist will:

Conduct a thorough virtual or in-person assessment
Identify the root cause of your pain (e.g. posture, joint stiffness, disc issues, nerve tension)
Create a customised treatment plan—including exercises, education, and, if needed, a referral for an MRI

Related Expert Guides You May Find Helpful:

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