There are many medications that help relieve pain associated with back and neck pain, including oral and topical medications. These medications may be prescribed, purchased over-the-counter, and—in one case—made at home.
Oral Medications for Back and Neck Pain
Oral pain medications come in the form of tablets, capsules, and liquid formulations. Examples of these types of pain medications include:
- NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are available over the counter or in prescription strength. NSAIDs can reduce pain, fever, and inflammation. There are many different NSAIDS available with a prescription. Celecoxib (e.g. Celebrex) is a newer class of NSAIDs called COX-2 inhibitors. A COX-2 inhibitor works similarly to traditional NSAIDs and may have fewer gastrointestinal side effects, such as bleeding and ulcers.
- Acetaminophen. Acetaminophen (e.g. Tylenol) works by blocking the transmission of pain signals to the brain. It is available over the counter. Acetaminophen may also be combined with other pain medications; these compound drugs are available with a prescription. It is not an anti-inflammatory and can be taken in-between the dosing of NSAIDs for better pain control.
- Antidepressants. Certain antidepressant medications, such as duloxetine and amitriptyline, have proven effective in managing certain types of chronic pain even without the presence of depression. Antidepressants are available only by prescription.
- Anticonvulsants (antiseizure medication). Anticonvulsants, such as gabapentin (e.g. Neurontin) and pregabalin (e.g. Lyrica), work by mimicking a neurotransmitter that down regulates the nerve signals in the brain that cause neuropathic pain. People with a herniated disc may experience neuropathic pain. Anticonvulsants are available by prescription only.
- Muscle relaxants. Muscle relaxants, such as cyclobenzaprine, relax tight, tense muscles. Muscle relaxants are often used to treat pain associated with musculoskeletal problems, such as back pain and whiplash. They are available only with a prescription and are typically prescribed on a short-term basis (2 to 3 weeks), although some people may take muscle relaxants for chronic pain.
- Opioids. Opioids, such as hydrocodone, tramadol, and oxycodone, are strong pain-relieving medications available by prescription only. They are typically prescribed for severe acute pain, such as while recovering from surgery. Some people may take opioids for chronic pain, such as back pain. Opioids have a relatively high risk of being misused and abused and are typically closely monitored by health care providers.
- Oral steroids. Oral steroids, such as methylprednisolone and prednisone, are anti-inflammatory medications. While not commonly prescribed for pain, they may occasionally be recommended to treat acute low back or neck pain due to inflammation. Oral steroids are generally prescribed for short bursts of therapy. Long-term steroid use requires a prescriber to recommend a tapering schedule because of the potential for serious side effects.
All medications, including over-the-counter medications, carry risks and side effects. A health care provider can help select which drugs are appropriate for a specific condition, symptom(s), or type of pain.
Topical Pain Medications
Topical pain relief medications include creams, gels, or patches applied to the skin. They are available in both over-the-counter and prescription strengths. They are often recommended to reduce localized pain, such as from an arthritic joint or sore muscle.
Pain relief medications that can be delivered topically include:
- Capsaicin. Pain from certain conditions, such as osteoarthritis and fibromyalgia, can be lessened with capsaicin. Capsaicin is a cream or gel made from chili peppers, and delivers a hot sensation to the area it is applied. Capsaicin can easily be made at home using all-natural ingredients, such as cayenne powder and coconut oil.
Read more about Capsaicin Cream for Joint Pain on Arthritis-health
- Counterirritants. Counterirritants (e.g. Icy Hot, Gold Bond) cause a hot or cold feeling brought on by ingredients such as menthol, wintergreen, and eucalyptus. Counterirritant creams and gels are often used for sore muscles and are typically safe to be used with other forms of pain relief. Some counterirritants, such as products that contain menthol, are available as skin patches.
- Lidocaine. Lidocaine is a local anesthetic cream, gel, or skin patch that causes temporary numbness, helping to minimize pain in the area it is applied. It is generally used for arthritis and other musculoskeletal conditions. Lidocaine is often combined with other ingredients in over the counter products. It is available as a prescription 5% patch (e.g. Lidoderm) and over the counter as a 4% patch (e.g. Salonpas).
- Topical diclofenac. This is a topical NSAID that is used to treat symptoms of arthritis, including pain, swelling, inflammation, and stiffness. It is available as a prescription only.
- Trolamine salicylate. This topical pain reliever cream is often recommended for arthritis pain. Trolamine salicylate (e.g. Aspercream, Myoflex) is chemically similar to aspirin and has a slight anti-inflammatory effect.
Read more about Topical Pain Relief for Arthritis on Arthritis-health
Topical pain relievers should always be tested on a small area of the skin, as some can cause irritation. Some people may also be allergic or have a sensitivity to the ingredients. Topical pain medications are often absorbed through the skin into the blood stream, which may result in possible drug interactions.