According to research cited by the American Chiropractic Association, nearly ⅓ of all working individuals in the United States complain of back pain. Some of the most common causes of back pain are inactivity (often due to long periods sitting at a desk), poor posture, strain on the body, and lack of good health and wellness. With this knowledge, it is no wonder that American’s are susceptible to back pain.

This leads many on a search for pain relief. What is the best medicine for lower back pain? What is the best pain medication overall? What is the difference between over-the-counter and prescriptions for chronic pain?

For the answers to these questions, and more, read below.

Over-the-Counter Pain Management

One of the most common treatments to reduce pain can be found in over-the-counter medications (OTC). These medications are widely available and usually well-tolerated, making them an easy choice for those dealing with intermittent pain. Unfortunately, their efficacy varies greatly between individuals, especially when their pain is persistent and severe.

Ibuprofen (Advil)

Ibuprofen for back pain is a common, though not always entirely effective, method for reducing pain. As a Nonsteroidal Anti-Inflammatory Drugs (NSAIDS), ibuprofen works by reducing inflammation within the body.

Get Back Your Normal Life Again

As pain specialists, we can guarantee that we are more than qualified in alleviating your pain and treating your condition.

However, relief comes with a trade-off as the overuse of Advil causes several common side effects impacting the health of the stomach and kidneys. Notably, side effects include stomach pain, upset, and ulcers.

Naproxen (Aleve)

Another common (and commonly overused) NSAID is naproxen. While this particular type of medication is marketed more toward muscle pain, its overall effect on back pain is similar to that of Advil and other medications in the same category.

Non-steroidal anti-inflammatory drugs are thought of as very safe, something which contributes to their overuse. Unfortunately, this is not necessarily the case; they still must be used with caution.

One of the most significant concerns with this particular class of anti-inflammatory medication is their tendency to raise the risk for certain medical conditions like heart attacks or strokes. It is still unknown why this correlation exists, so caution is recommended when taking these drugs. Use the lowest dose possible as infrequently as you can.

Acetaminophen (Tylenol)

Of the above-mentioned pain medicines, acetaminophen also works to stop the pain and fight fever. However, this medication has far less serious side effects on your digestive tract and heart.

Prescription Pain Management

For individuals who cannot find relief through OTC medications or are suffering from chronic pain, prescription management is often the next step. While the potential side effects of these medications are potentially more likely than their OTC counterparts, often relieving pain is worth the increased risk of adverse effects.


Opioids are a controversial topic when clinicians discuss pain management. In fact, it’s something we ourselves have talked about on this blog ourselves. The reason for caution around this class of prescription is, while it was once the gold-standard for pain management, the unintended side effect of these medications was an increased likelihood of dependency and addiction.

Opioids work by blocking the opioid receptors in the brain— something which prohibits the brain from recognising pain messages. While opioids are generally good for pain as a result of physical trauma (such as surgery), their efficacy decreases when used in treatment for nerve pain.

Muscle Relaxants

Best for acute pain, muscle relaxants are prescribed infrequently. The hesitation is due to some commonly unavoidable side effects such as dizziness, fatigue, and weakness.

However, for acute back and neck pain, short term use of muscle relaxants can help other treatment methods such as physical therapy work better overall. When the pinched muscles have assistance to help relax and stay relaxed, it allows you to benefit more from the movement and stretching found in physical therapy.


To this day doctors are still unsure of why antidepressants tend to work well for physical pain. While there are many running theories, such as the medication’s effect on neurotransmitters in the brain and spine, a proven theory is not yet developed.

However, as these antidepressants are effective, pain management has grown to be common off-label use for this class of drugs. Particularly effective are those within the Serotonin-Norepinephrine Reuptake Inhibitors (SNRI) category, making medications such as Cymbalta (duoluxine) are categorical favorites.

Steroid Injections

For individuals who suffer from arthritis pain, prescription drugs that fall into the corticosteroid family are an effective and powerful form of pain relief. These medications are given in the form of injections to the affected site and are often repeated in scheduled sets of 3 to 6  

Oral Steroids

But not all steroids for back pain relief are injected. The option for oral steroids also exists, providing a medication that works to decrease inflammation without the use of narcotics. However, as long-term use can cause adverse side effects and complications, they are generally only prescribed for a maximum of two weeks at a time. For persistent pain, alternative methods are recommended.

Alternate Treatments

As referenced above, several alternative therapies exist to help back pain. While these treatments can be used by themselves, they are generally more effective when used in conjunction with over the counter pain relievers, prescriptions, or some other medication-based care.

Physical Therapy

A physical therapist works with the anatomy of the body, teaching individuals exercises, stretches, and movement techniques to help their condition. Pain is reduced in many ways, such as cultivating better core strength, expanding range of motion, and promoting resilience.

Occupational Therapy

Commonly confused with physical therapy, occupational therapists take a more rounded, whole-person approach to their solutions. This could include teaching clients new ways to do daily tasks to reduce their pain and provide external resources for pain management.


In traditional Chinese medicine, the body works off a series of meridians. These are pathways that carry chi, or energy, around the body to promote and maintain wellbeing. When there is a block along with one of the meridians, ailments arise.

When experiencing back pain, acupuncture unblocks your energy pathways by using very fine needles to manipulate energy points on the body. Looking at this logic through a Western lens, we can assume each energy point is a cluster of neurons that, when manipulated, encourages the body’s natural pain management system.

Many individuals find at least some degree of benefit when using acupuncture as part of their treatment plan, often citing the appointments themselves as relaxing.


As it relates to back pain, working with a massage therapist may significantly reduce your pain in the short term, and promote muscle loosening and relaxation after repeated appointments. These effects are not only accomplished by the massage therapist manipulating the muscles themselves but by the increased blood flow, such motions provide.

Arizona Pain Management Experts

Back pain is a widespread problem without a single solution. Individuals respond to medications differently, making treatment plans as varied as patients.

The Arizona Pain and Spine Institute boast a full team of seasoned professionals who specialize in minimally invasive and clinically proven modalities to help manage both long and short-term pain. We make a point to stay on the cutting edge of new technologies to help reduce pain and increase the quality of life. Contact us at (480) 986-7246 for more information on the service we provide, find which doctor is right for you, and get on the path to discussing your next treatment options.