When it comes to treating low back pain, many people assume that medications are the obvious answer. Recent research suggests the story isn’t quite that simple.
The American College of Physicians recently reviewed the best available scientific evidence to help guide patients and health care providers on how to manage low back pain. Their guideline, published in Annals of Internal Medicine, was based on high-quality, placebo-controlled clinical trials.
Because of this rigorous approach, it’s considered one of the most reliable summaries of what actually works — and what doesn’t. What they found may surprise you.
For acute low back pain — pain lasting fewer than four weeks — most commonly prescribed medications didn’t provide meaningful relief. The panel found no benefit, or clear evidence of ineffectiveness, for several drug classes that are frequently used in practice.
These included acetaminophen (such as Tylenol), opioid pain medications, anti-seizure drugs like gabapentin, oral steroids such as prednisone and anti-anxiety medications including benzodiazepines like Valium or Librium. In study after study, these drugs performed no better than a placebo when it came to improving pain or function.
Nonsteroidal anti-inflammatory drugs (NSAIDs) — including ibuprofen (Advil), naproxen (Aleve), and aspirin-containing products like Anacin — showed only small benefits.
While they may help some people, that limited relief needs to be weighed against their known risks. NSAIDs can increase the chance of heart attack and stroke, cause stomach ulcers or bleeding, and impair kidney function. For many patients, especially older adults or those with heart, kidney or digestive conditions, the potential downsides may outweigh the modest benefit.
Muscle relaxants have also been commonly prescribed for back pain. Earlier studies suggested they might help, but more recent research hasn’t shown consistent or meaningful improvement. On top of that, these medications often cause side effects such as drowsiness, dizziness and blurred vision — problems that can interfere with driving, work and everyday activities.
So what does all of this mean for someone with acute low back pain?
In short, medications may not be as helpful as many people expect.
The good news is that most cases of acute low back pain improve on their own over time. Staying as active as possible within your comfort level, along with simple strategies like heat or ice, is often enough to support recovery. As always, it’s important to seek appropriate professional care to confirm an accurate diagnosis and develop a treatment plan tailored to your individual needs.
Dr. Brian Grieves is a doctor of chiropractic with a master’s degree in public health and a member of the Shawano Community Health Action Team. For more information, call 715-524-8722.
