Every day, an estimated 30 million people worldwide take a non-steroidal anti-inflammatory medication, or NSAID.1

These versatile medications, available in over-the-counter and prescription strength, treat both pain and inflammation. Inflammation is a contributing factor in most back pain conditions, so reducing inflammation is important to alleviate the pain.

See Causes of Lower Back Pain and Causes of Upper Back Pain

NSAIDs are used to address acute (short term) as well as chronic back, neck, and muscle pain.

See Pain Management for Chronic Back Pain

Painkiller for Back Pain and More

Common uses for NSAIDs include treatment for:

  • Mild or moderate back pain, tenderness, inflammation, and stiffness
  • Activity-related pain or discomfort (e.g. pain that follows sports or activities such as housework, shoveling snow, or other exertion)
  • Pain related to muscle strain in the low back and elsewhere
  • Neck stiffness related to muscle, ligament, or tendon strains or damage
  • Osteoarthritis joint pain
  • Rheumatoid arthritis
  • Ankylosing spondylitis
  • A number of other forms of arthritis pain

This article provides information on how non-steroidal anti-inflammatory medications can be helpful against back, neck, and other pain, as well as several potential risks and complications to be considered.

Most Common Types of NSAIDs

NSAIDs comprise a large class of drugs that act by hampering body substances called prostaglandins, which trigger feelings of pain, giving NSAIDs fever-reducing, pain-relieving, and anti-inflammatory properties. There are many types of non-prescription (over-the-counter) and prescription NSAIDs. The four NSAIDs most often used to treat many types of back and neck pain are:

  • Aspirin (brand names include Bayer, Bufferin, and Ecotrin, St. Joseph)
  • Ibuprofen (Advil, Motrin)
  • Naproxen (Aleve, Anaprox DS, Naprosyn)
  • Celecoxib (Celebrex)
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Other Forms of NSAIDs

In addition to the above, NSAIDs come in forms other than those taken by mouth. For example:

  • Ketorolac can be given as an intravenous, intramuscular, or intranasal drug, making it useful after surgery or if the patient cannot eat.
  • Diclofenac is available topically as a gel (Voltaren), patch (Flector), or solution (Pennsaid). The medication is applied directly to the area of pain. Topical forms reduce gastrointestinal and other potential side effects of NSAIDs.

Effective Use of NSAIDs

Taking NSAIDs continuously, rather than just at the onset of pain, helps build up the body’s anti-inflammatory blood level, resulting in a better healing environment in the affected area. The efficacy is markedly lower if NSAIDs are taken only when experiencing pain.

See Using Medication to Manage Pain and Reduce Sleep Problems

These are other points to be aware of while taking NSAIDs:

  • Checking with the doctor. Because NSAIDs have risks and complications, it is important to keep the doctor informed. People taking NSAIDs for long periods are advised to see the doctor regularly so any side effects can be monitored. In some cases, a change in medication may be required.
  • Using as little as possible. The U.S. Food and Drug Administration advises that the lowest effective dose of NSAIDs be used, and then for only as long as necessary.
  • Combining with acetaminophen. NSAIDs and the pain relief medication acetaminophen (e.g. brand name Tylenol) work differently, so sometimes doctors recommend taking both medications. This often offers better pain relief than taking one type of pain medication. Some people find it also helps lessen the pain as one dose wears off, alternating between the two—for example, taking a dose of ibuprofen, then 3 hours later taking a dose of acetaminophen.

Any adverse reactions from taking an NSAID, or any other medication, should be reported to the doctor without delay.

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When NSAIDs Are Not Advised

People having a lumbar fusion surgery are typically advised not to take NSAIDs for at least 3 months after surgery due to concerns about the impact NSAIDs may have on bone healing.

Many doctors also tell patients to stop using NSAIDs prior to other types of surgery because the medication poses an increased risk of bleeding.


  1. Gargiulo G, Capodanno D, Longo G, Capranzano P, Tamburino C. Updates on NSAIDS in patients with and without coronary artery disease: Pitfalls, interactions, and cardiovascular outcomes. Expert Review of Cardiovascular Therapy, 12 (10) (2014), pp. 1185–1203. www.ncbi.nlm.nih.gov/pubmed/25220474

Complete Listing of References