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Can Over the Counter Medications Relieve Back Pain?

The final goal of all therapies is to achieve a back that is painless and functional without drugs. Once maximum function has been reached, medicines can be gradually decreased so you can function without them. But do take them to reduce pain so you can keep moving.


Acetaminophen (Tylenol) is a pure pain reliever (analgesic) without any anti-inflammatory effect. The maximum dose is 4000 mg per day (six tablets of Tylenol Arthritis). The long-acting form of acetaminophen (650 mg) lasts six to eight hours. Acetaminophen is easily tolerated and doesn’t upset your stomach. However, for many people, the medication is not powerful enough to decrease pain.

Nonsteroidal anti-inflammatory drugs (NSAID)

NSAIDs have pain-relieving and anti-inflammatory effects. Aspirin was the first NSAID and is still a very powerful drug in adequate doses. For example, patients with rheumatoid arthritis will ingest sixteen tablets a day in divided doses. At this dose it is analgesic and anti-inflammatory. At lower doses, aspirin is analgesic with less anti-inflammatory effects. The problem with aspirin is that it irritates the stomach and can cause ulcers with bleeding. It can also have bad effects on kidney function. At toxic doses, aspirin can cause dizziness, loss of hearing, and even coma. If you take aspirin at a dose higher that 81 mg (baby aspirin) for any length of time, you should be evaluated by a physician.

A number of newer NSAIDs are available without a prescription.

  • Ibuprofen (Advil, Nuprin, Motrin IB)
  • Naproxen (Aleve)
  • Ketoprofen (Orudis KT)

The dose for each of these NSAIDs is different, so read the label on the box to determine the effective, safe dose. If one NSAID does not work, try another, because one that helps another person may not help you. If you take an NSAID for two weeks without benefit, then you need to see your doctor. Potential side effects of NSAIDs are that they can cause stomach pain and bleeding, elevations in blood pressure, and decreased function of the kidney in a few people. These drugs need monitoring by your doctor if you take them on a continuous basis.

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More potent and more effective NSAIDs are available by prescription. These include the new COX-2 inhibitors, which are as effective as the NSAIDs without as many gastrointestinal side effects.

It is important to understand how long your dose of medicine will be effective, what side effects may occur, and how long you need to remain on a medication.

From Back in Control by Dr. David Borenstein