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Strong Painkillers For Back Pain

In this article you will find everything you need to know about strong painkillers for back pain and the safer alternatives.

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.

What Causes Back Pain? 

The most complicated part about back pain is its confusing nature. This pain can occur literally anywhere along your whole back area. 

For some people, it starts as neck pain – in the form of periodic painful muscle spasms that later on go on to involve the entire back region. For others, it exists as chronic pain that remains limited to the lower back area only. [2]

Several underlying causes could give rise to chronic back pain and compromise your well-being. Some of the major causes include: 

  • Lifting heavy weights or objects that could put excessive pressure on the back muscles, leading to muscle or ligament sprains,
  • Herniation (protrusion) or rupture of the discs in the lower back region. This is one of the most common causes of low back pain,
  • Osteoarthritis can also cause age-related wear and tear in the back area leading to back pain, 
  • A condition called ‘sciatica,’ where a nerve in the lower lumbar region gets compressed, leading to the radiation of pain from the lower back area to the back of the legs.

Whatever the reason behind your back pain is, there is sufficient health information available to deal with it accordingly and intervene within time to stop it from becoming a chronic condition, which is indeed problematic.   

Strong Painkillers for Back Pain

Whenever we come across a minor or major inconvenience, our first instinct is to work on resolving it as soon as possible. Similarly, when it comes to suffering from chronic, debilitating pains such as lower back pain, it is obvious that anyone would want to jump at their chance of taking the next over-the-counter analgesic meds that they could come across to get rid of this pain as soon as possible. [3]

According to the National Institute of Health, several pieces of research are going on to discover a final, non-surgical treatment plan to resolve back pain, with special emphasis on chronic low back pain. [4]

However, the current pain medications, preferably analgesics that are prescribed to people suffering from back pain, have been highlighted and discussed in the preceding section. 

While proper medical advice and tailored prescription from a doctor are better than over-the-counter pain medicine, it is equally important to know about the drugs that you might get for your acute or chronic back pain. 

Strong painkillers for back pain

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

This category of drugs is what mostly comes under the category of OTC or ‘over-the-counter’ pain medications. These pain reliever meds are so readily available and within reach of almost anyone that they are usually the first line of treatment that people look forward to when treating their back pain by themselves. [5]

In the majority of people, especially when the back pain is musculoskeletal in nature, the pain usually resolves after a day or two of taking these medicines. Some people also prefer using muscle relaxant analgesic creams to help resolve their pain.

Acetaminophen or Paracetamol is one of the most popularly used NSAIDs. It is commonly used for relieving fever and body pains, such as headaches, lower back pain, menstrual cramps, osteoarthritis-related pain, etc.

This drug acts by blocking the cyclooxygenase (COX) pathway in the central nervous system, which is responsible for mediating pain and inflammatory responses in the body. [6]

Some of the commonly available NSAIDs in the market are Tylenol, Panadol, Ibuprofen (Motrin), Diclofenac (Voltaren), etc. 

Side Effects: 

Acetaminophen is usually a safe class of drugs. However, people with liver diseases should avoid taking this drug. If people overdose on this drug, they may experience serious side effects such as nausea, vomiting, sweating, and yellowing of the skin. 

Moreover, people who suffer from acidity and other related issues should use NSAIDs with precautions as they may erode the gastrointestinal lining, leading to the formation of ulcers. 

Opioids as strong painkillers for back pain

Opioids are stronger painkillers and are often prescribed for back pain that seems to be persistent in its frequency of occurrence. Unlike NSAIDs that are used over-the-counter and for short-term, acute pain, opioids are used only after getting prescribed by a doctor since they are designed to treat moderate to severe pain. 

Opioids work to block the pain signals between the brain and the body. Therefore, people with chronic low back pain can especially benefit from them. [7]

Some of the commonly prescribed opioids for back pain include Tramadol (Ultram), Oxycodone (Roxicodone, OxyContin), Hydrocodone (Vicodin), etc.

Side Effects: 

However, there is also a looming concern regarding their mechanism of action. Since opioids seem to be impacting the brain directly, people seem to develop a dependency on them after long-term usage. [8]

This makes the usage of such drugs controversial, and this is also why its usage is limited to catering to emergency-related or chronic pains only. 

The side effects that may develop due to the usage of opioids include nausea, constipation, vomiting, pruritus, and drowsiness. 


Although a less used option, antidepressants have also been linked to helping people relieve their pain. They can help with pain relief, especially in the back region, although it may take longer than the usual pain medications.

Antidepressants have their way of combating pain. They work to increase those neurotransmitters in the back (or any other affected) region that help reduce pain signals within that area.

This is indeed a helpful mechanism that helps the body get rid of these painful signals that were otherwise keeping the affected person on their toes with all the discomfort. [9]

Some of the commonly used antidepressants that are used for treating back pain include Amitriptyline (Elavil), Duloxetine (Cymbalta), Desipramine (Norpramin), Venlafaxine (Effexor XR), etc. 

Side Effects: 

Perhaps the only downside that seems to be attached to antidepressants is their longer duration of action. Apart from that, their usage can also lead to some side effects such as nausea, dry mouth, insomnia, dizziness, constipation, or diarrhoea.

Anticonvulsants as strong painkillers for back pain

Anticonvulsants are routinely used to treat seizures. However, since they are designed to treat neurological conditions, they can very much exert their impact on back pain, especially the one generated due to nerve-related disorders such as sciatica, disc compression, and so on. [10]

Therefore, blocking these painful signals not only helps the person steer away from developing chronic back pain but also helps in weaning off the sharp, shooting stabs that are a characteristic feature of nerve-related pain. 

Some of the common anticonvulsants that are used for treating back pain include Gabapentin (Neurontin), Pregabalin (Lyrica), Lamotrigine (Lamictal), etc. 

Side Effects:

The common side effects that develop due to the usage of anticonvulsants include drowsiness, restlessness, uncontrollable eye movements, loss of appetite, nausea, and vomiting. 

The Bottom Line

Although not usually a matter of grave concern, back pain can indeed be exceptionally debilitating for anyone who develops it. This pain is uncomfortable and significant enough to cause you to give up on your daily activities. 

However, by using strong painkillers, you can easily bypass this pain’s unwanted and uncomfortable effects. In addition, these pain medications are reliable and can help you get rid of both your acute and chronic low back pain that seem to hinder your ability to get through the day! 

The only thing that you need to take care of is that you consult a healthcare professional to prescribe these pain meds to you instead of self-medicating to avoid developing any side effects.

Other treatment options


Some structures have a poor blood supply, which is why they can struggle to heal on their own. It is the oxygen and nutrients in our blood supply that help to heal these structures.

Prolotherapy involves the injection of a regenerative solution into these structures to provide a direct supply of what is needed to heal them and provide pain relief.

As the treatment is helping to treat the root cause of the problem, it is deemed to be a permanent fix.

Frequently Asked Questions about strong painkillers for back pain

Is Tramadol good for back pain?

Tramadol, a synthetic opioid, is often prescribed to relieve pain. It is indeed a good pain reliever and helps in getting rid of chronic low back pain when used within the prescribed limits. 

Is Tramadol stronger than Ibuprofen 800mg?

Usually, there is no means of comparing one drug with the other when it comes to judging its effectiveness. However, Tramadol (opioid) was found to have the upper hand over Ibuprofen (NSAID) since it seems to affect the central nervous system and calm the pain down more effectively than over-the-counter painkillers. 

Is Naproxen 500mg a strong painkiller?

Naproxen 500 mg is indeed a strong painkiller that can help get rid of arthritis, gout, and low back pain in no time. It is indeed a strong dose and when used within the safety limits, it can help get rid of any kind of inflammatory pain in no time. 

Is Tramadol stronger than Codeine?

Tramadol and Codeine both belong to the same category of drugs – opioids. Both have the same mechanism of action, and similarly, both seem to be equally effective when it comes to imparting their pain-relieving effects.

Which is better for back pain Tramadol or Ibuprofen?

Both Tramadol and Ibuprofen are strong and effective painkillers. However, they have their distinct uses, and it is best if they are taken accordingly. 

Mostly, Ibuprofen is prescribed for short-term, inflammatory pain relief, whereas Tramadol is prescribed for both generalized and nerve-related pain. It is also best for chronic pain conditions. 

Is it okay to take Tramadol and Ibuprofen together?

Yes, it is very safe to take Ibuprofen and Tramadol together. Both these drugs seem to have no significant interactions and so cannot impose any unwanted side effects or reactions when taken together. 


  1. Casiano VE, Sarwan G, Dydyk AM, et al. Back Pain. [Updated 2022 Feb 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538173/
  2. Urits, Ivan & Burshtein, Aaron & Sharma, Medha & Testa, Lauren & Gold, Peter & Orhurhu, Vwaire & Viswanath, Omar & Jones, Mark & Sidransky, Moises & Spektor, Boris & Kaye, Adam. (2019). Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment. Current Pain and Headache Reports. 23. 10.1007/s11916-019-0757-1.
  3. Migliorini, F., Maffulli, N., Eschweiler, J., Betsch, M., Catalano, G., Driessen, A., … & Baroncini, A. (2021). The pharmacological management of chronic lower back pain. Expert opinion on pharmacotherapy, 22(1), 109-119.
  4. Chou, R., & Huffman, L. H. (2007). Medications for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Annals of internal medicine, 147(7), 505-514.
  5. van der Gaag, W. H., Roelofs, P. D., Enthoven, W. T., van Tulder, M. W., & Koes, B. W. (2020). Non‐steroidal anti‐inflammatory drugs for acute low back pain. Cochrane Database of Systematic Reviews, (4).
  6. Enthoven, W. T., Roelofs, P. D., Deyo, R. A., van Tulder, M. W., & Koes, B. W. (2016). Non‐steroidal anti‐inflammatory drugs for chronic low back pain. Cochrane Database of Systematic Reviews, (2).
  7. Deyo, R. A., Von Korff, M., & Duhrkoop, D. (2015). Opioids for low back pain. Bmj, 350.
  8. Wachholtz, A., & Gonzalez, G. (2014). Comorbid pain and opioid addiction: long term effect of opioid maintenance on acute pain. Drug and alcohol dependence, 145, 143-149.
  9. Ferreira, G. E., McLachlan, A. J., Lin, C. W. C., Zadro, J. R., Abdel-Shaheed, C., O’Keeffe, M., & Maher, C. G. (2021). Efficacy and safety of antidepressants for the treatment of back pain and osteoarthritis: systematic review and meta-analysis. bmj, 372.

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