Strong Painkillers for Back Pain: What Works & What to Avoid
26 October, 2025
In this article, you will find everything you need to know about strong painkillers for back pain and the safer alternatives, including an advanced technique called Prolotherapy.
Undoubtedly, back pain is one of the most uncomfortable and painful situations to deal with in an individual’s life. If you are a working person or someone whose job requires them to stand or maintain a specific posture for prolonged hours, this back pain can be one of your worst nightmares, just like that!
The majority of the people have been seen to suffer from low back pain, mainly because our sitting and lying postures make it compromising for the poor back to relax.[1]
Chronic low back pain is indeed problematic, and once it manifests itself, it will take way longer than the other body aches to go away because of the increased mobility of this area.
Understanding Back Pain and Its Impact
Back pain is one of the most common reasons for doctor visits and work absences worldwide. It can range from a dull, persistent ache to sharp, debilitating pain that limits movement and quality of life.
Certain risk factors, such as age, occupation, and lifestyle, increase the likelihood of developing back pain.
Back pain may be acute (lasting a few days to weeks) or chronic (lasting longer than three months), and chronic low back pain is a common and challenging condition that often requires specialized management. It can result from muscle strain, herniated discs, arthritis, or other spinal conditions.[1]
E-E-A-T: Why Trust ProHealth Clinic for Back Pain Advice?
At ProHealth Clinic, our content is created and reviewed by experienced clinicians with advanced training in musculoskeletal and pain medicine. We follow the highest standards of Experience, Expertise, Authoritativeness, and Trustworthiness (E-E-A-T) to ensure you receive reliable, up-to-date, and actionable information for your back pain.
What Causes Back Pain?
Muscle or Ligament Strain: Lifting heavy objects, sudden movements, or poor posture can strain back muscles and ligaments.
Herniated or Bulging Discs: Discs that cushion the vertebrae can rupture or bulge, pressing on nerves.
Arthritis: Osteoarthritis can affect the lower back, sometimes leading to spinal stenosis.
Skeletal Irregularities: Conditions like scoliosis can cause chronic back pain.
Osteoporosis: Weak, brittle bones can lead to painful fractures.
Injury or Trauma: Falls, accidents, or sports injuries can trigger acute or chronic pain.
Some of these conditions are considered pain disorders, which may require specialized treatment approaches.
Symptoms of Back Pain
Dull, aching, or sharp pain in the back
Pain that radiates down the leg (sciatica)
Stiffness or reduced range of motion
Muscle spasms
Numbness or tingling in the legs or feet
Pain that worsens with movement, sitting, or standing
If you experience sudden, severe pain, loss of bladder or bowel control, or significant weakness, seek urgent medical attention.
Are Strong Painkillers Effective for Back Pain?
Many people with back pain seek stronger painkillers, such as opioid pain relievers, for relief. Opioid pain relievers are prescription-only medications used for severe cases and work by acting on nerve receptors to reduce pain. However, research shows that opioids and other stronger painkillers are often not effective for long-term back pain and carry significant risks. Possible side effects include addiction, drowsiness, constipation, and more serious risks such as overdose.[2] While some people may feel relieved after taking these medications, many do not experience lasting benefit.
The National Institute for Health and Care Excellence (NICE) and other expert guidelines recommend against routine use of stronger painkillers for back pain. There is no single best medicine for back pain, as effectiveness varies between individuals. Instead, a combination of targeted therapies, lifestyle changes, and minimally invasive treatments is preferred.[3]
Medication Options for Back Pain
Over-the-counter NSAIDs (such as ibuprofen) are often the first line of defense for mild to moderate back pain, helping to reduce inflammation and discomfort. A medicine called co-codamol, which combines codeine and paracetamol, is also available for moderate pain but should be used with caution due to its opioid content and risk of dependency. These drugs are common pain relievers, and those with fewer side effects, such as acetaminophen, are generally preferred for long-term use.
It is important to inform your doctor about any other medications you are taking to avoid potential drug interactions. Be aware that NSAIDs and acetaminophen can cause side effects such as bleeding, liver damage, and stomach pain. People with liver disease should consult their doctor before using these painkillers.
For more severe pain, a doctor may prescribe a medicine called a muscle relaxant, antidepressant, or anticonvulsant. Antidepressants may be used for chronic low back pain, especially if depression is also present, as some can help treat depression and chronic pain. Pain relief gel is another option for targeted, topical relief.
Avoid drinking alcohol while taking opioid pain relievers or muscle relaxants, as this can increase the risk of drowsiness, breathing difficulties, or overdose. Strong painkillers like opioids are generally not recommended for chronic back pain due to their limited effectiveness and risk of side effects and dependence.
If your pain persists beyond a short time or if symptoms worsen, seek medical advice. Always consult your healthcare provider before starting any new medication, especially if you have other health conditions or are taking other medicines.[4]
Over-the-Counter Painkillers: What You Need to Know
Over-the-counter (OTC) painkillers are widely used to relieve pain and manage minor pain without the need for a prescription. These medicines are easily available from pharmacies and shops, making them a convenient first step for those experiencing back pain, joint pain, or everyday aches.
The most common OTC painkillers include paracetamol and ibuprofen. Paracetamol is often chosen to relieve pain and reduce fever, while ibuprofen belongs to a group of medicines called nonsteroidal anti inflammatory drugs (NSAIDs), which help decrease inflammation as well as pain. For some people, low-dose codeine is available in combination with paracetamol for short term relief of more persistent discomfort.
These painkillers work by blocking the signals in the brain and spinal cord that cause you to feel pain, or by reducing inflammation in the body. They are generally safe for most people when used as directed, and can be effective for minor pain, muscle aches, or pain caused by inflammation.
If you find that OTC painkillers do not relieve your symptoms, or if your pain continues for more than a few days, it’s important to speak with a pharmacist or doctor. Always follow the instructions on the packaging, and let your healthcare provider know about any other medicines you are taking to avoid potential interactions.
OTC painkillers can be a helpful part of your pain relief toolkit, especially for minor pain and inflammation, but should be used responsibly as part of a broader approach to managing back pain.
Case Study: Back Pain Recovery Without Strong Painkillers
Patient: 47-year-old female, office worker. Symptoms: Persistent lower back pain radiating to the left leg, worsened by sitting. Treatment: Physical therapy, anti-inflammatory medication, ergonomic adjustments at work, and a course of prolotherapy. Outcome: Significant pain reduction within six weeks, full return to work and exercise, no need for opioids or surgery.
“I was worried I’d need strong painkillers, but ProHealth Clinic helped me recover naturally and get back to my normal life.”
Treatments for Back Pain: What Really Works?
Many of these treatments have relieved symptoms for patients with back pain.
Physical Therapy: Targeted exercises to improve flexibility, strengthen supporting muscles, and relieve nerve pressure.
Anti-inflammatory Medications: NSAIDs can help reduce pain and swelling.
Heat and Ice Therapy: Alternating hot and cold packs can ease muscle tension and inflammation.
Manual Therapy: Hands-on treatments such as massage or spinal manipulation may provide relief for some patients.
Activity Modification: Avoiding activities that worsen symptoms, staying active within comfort limits, and taking regular breaks during activities can help prevent pain flare-ups.
Corticosteroid Injections: For severe or persistent pain, injections may reduce inflammation around the nerve.
Surgery: Reserved for rare cases with severe nerve compression or when conservative treatments fail.
Prolotherapy
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat back pain.
Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to help with back pain.
As prolotherapy is helping to treat the root cause of back pain, it is deemed to be a permanent fix, preventing the symptoms from returning.
Prevention Tips for Back Pain
Maintain a healthy weight to reduce spinal stress
Practice good posture when sitting and standing
Use proper lifting techniques
Stay active with regular exercise and stretching
Strengthen your core and back muscles
Avoid prolonged sitting or inactivity
Frequently Asked Questions
Are strong painkillers safe for back pain?
Strong painkillers (opioids) are generally not recommended for back pain due to limited effectiveness and significant risks, including addiction and side effects. Safer, evidence-based alternatives are preferred.
What is the best pain relief for back pain?
The best pain relief combines physical therapy, anti-inflammatory medications, activity modification, and minimally invasive treatments like prolotherapy. Always consult a healthcare professional for a tailored plan.
Can back pain go away on its own?
Many cases of back pain improve with conservative treatment and time. However, persistent or severe symptoms should be evaluated by a specialist.
Is exercise good for back pain?
Yes, gentle exercise and stretching are usually beneficial for back pain. Physical therapy can help relieve nerve pressure, improve flexibility, and prevent future flare-ups. Avoid activities that worsen your pain and consult a professional for a personalized program.
When should I see a doctor for back pain?
Seek medical attention if you experience severe pain, weakness, numbness, or loss of bladder or bowel control. These may indicate serious nerve compression requiring urgent care.
Contact ProHealth Clinic Today for Your FREE 15-Minute Discovery Call
Don’t let back pain control your life any longer. Join the thousands of patients who have found lasting relief through prolotherapy at ProHealth Clinic.
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Author Bio
Having performed over 10,000 procedures, Mr Eaton is one of the UK’s leading practitioners in the field of treating back pain, with patients travelling to see him from across the UK, Europe, and the Middle East. With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with back pain and providing effective treatment options to alleviate them. He qualified in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further qualifications at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany. Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists. Linkedin profile
References
Hartvigsen J, et al. “What low back pain is and why we need to pay attention.” Lancet. 2018;391(10137):2356-2367. Read
Dowell D, Haegerich TM, Chou R. “CDC guideline for prescribing opioids for chronic pain—United States, 2016.” JAMA. 2016;315(15):1624-1645. Read
National Institute for Health and Care Excellence (NICE). “Low back pain and sciatica in over 16s: assessment and management.” NICE guideline [NG59]. 2020. Read
Foster NE, et al. “Prevention and treatment of low back pain: evidence, challenges, and promising directions.” Lancet. 2018;391(10137):2368-2383. Read
