Low Back Pain Medications

Because of the upright architecture of the spine and body, the bottom of the vertebral spine must bear heavier loads, rather then the dispersal of energy throughout the spine as would be the case with our four legged creatures. The bottom two discs of our spine especially, L4-L5 and L5-S1, bears the heaviest loads and is the most vulnerable to injury. The structures of the low back are heavily fortified to take on these heavy loads, as the vertebral bones are denser and stronger, and the lumbar discs are thicker. Yet, these structures are still subject to wear and tear, and injury. The interesting thing about injuries and degenerative changes to the lower back is that we often don't even notice them when they are occurring. The body has an amazing ability to adapt to its environment, and to pathological changes within our own body, without drastically altering the way we move and our quality of life. As long as the nerves of the spinal cord and nerve roots remain uncompromised, we are likely to go on, not even noticing the changes. In the event that the discs herniated, which involves large cracks or fissures in its wall, and the material in its nucleus projects into the nerves, we may experience significant pain. The pain may be significant, and may be persistent, occurring throughout the day and throughout the night. Other conditions that may cause lower back pain include facet arthropathy, protruded discs, lumbar spinal stensosis, and foraminal stenosis.

Often the effects of these back conditions, especially the ones that cause compression of the nerves, cause lower back pain that can disrupt the quality of your life. If the pain levels are holding you back, you may elect to try to treat the pain yourself, with over the counter pain medications, or you may go to your doctor for more help. Over the counter low back pain medications typically fall under the category of NSAIDs, or nonsteroidal anti-inflammatory medications. These NSAIDs may be classified together or sub-categorized into those that are available over the counter (OTC), and those that are available only be a medical prescription. The OTC NSAIDs include the non Cox-2 inhibitors. These meds include aspirin (acetylsalicyclic acid),Ibuprofin, Naproxin, Meloxicam, and aspirin. These medications are typically taken orally, and their active ingredients are absorbed through the stomach and intestinal walls. These drugs affect the body in several ways, particularly through the inhibition of the body cells from releasing Prostaglandins into the bloodstream. The secretion of prostaglandins into the bloodstream is one of the factors that initiates inflammation in the body, which involves several processes that serve to heal injured body tissues. Inflammation in the body also causes our experience of pain.

Cox-2 inhibitors (Coxibs) are also taken orally, and are also designed to prevent or stop pain or inflammation. Many patients prefer these meds over traditional NSAIDs because they provide more pain relief, or provide equal pain relief in addition to fewer side effects. These medications, which include Celebrex and VIOXX, specifically target the enzyme known as Cox-2, which is responsible for inflammation and pain. Today, VIOXX is no longer approved for US markets due to the increased risk of cardiovascular disease.

Cox-2 and NSAIDs are more effective for pain that is isolated to the lower back, and when the cause of back pain is not due to back spasms. For medications that cause muscle spasms and nerve pain, other specialized medications may be required. Other low back pain medications include:
  • Oral steroids
  • Pain injections (which typically include cortical steroids)
  • Muscle Relaxants
  • (Opioid based) Narcotics