Back Pain Research Today is a free monthly online journal that collates and summarizes the latest research about Back Pain, including details on lower back pain, sciatica, treatment, prevention, medication.

The use of medication in low back pain.

Mens JM

Department of Rehabilitation Medicine, Erasmus Medical Centre, University Medical Center, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. j.mens@erasmusmc.nl

The choice of medication for low back pain should be evidence based and tailored as much as possible to suit the individual patient. Acetaminophen (paracetamol), mild opioids and NSAIDs are the first-line drugs for low back pain but there is no evidence that one is more effective than the others. Non-benzodiazepine muscle relaxants (with or without pain medication) could be considered as second-line drugs in acute low back pain, and cyclic antidepressants in chronic low back pain. The risk of adverse side effects can be reduced by taking account of the patient's medical history and by using a test dose. The realization that symptoms other than pain are sometimes more important and/or easier to overcome can increase the benefits of medication. The long-term effects of medication can be improved when it is combined with non-drug interventions.

Published 13 June 2005 in Best Pract Res Clin Rheumatol, 19(4): 609-21.
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