[Table, Medicines for Chronic Low Back Pain]. - Comparative Effectiveness Review Summary Guides for Consumers

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Comparative Effectiveness Review Summary Guides for Consumers [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2005-.

This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Comparative Effectiveness Review Summary Guides for Consumers [Internet].

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Type of Medicine	About the medicine:	Researchers found:
NSAIDs (nonsteroidal anti-inflammatory drugs) Examples include celecoxib (Celebrex^®), diclofenac (Zorvolex^®), ibuprofen (Advil^®, Motrin^®), meloxicam (Mobic^®), naproxen (Aleve^®), and piroxicam (Feldene^®)	A type of medicine to reduce pain and swelling	NSAIDs help to reduce pain.
Antidepressants SNRI (serotonin and norepinepherine reuptake inhibitor) antidepressants Duloxetine (Cymbalta^®) Tricyclic antidepressants Examples include amitriptyline (no brand name), desipramine (Norpramin^®), imipramine (Tofranil^®), and nortriptyline (Aventyl^®, Pamelor^®)	A type of medicine made to treat depression but also sometimes used to treat pain Note: Some antidepressants may help treat pain. Taking an antidepressant for low back pain does not mean that the problem is in your mind.	The SNRI antidepressant duloxetine (Cymbalta^®) helps a little to reduce pain and may help you return to your daily activities. Tricyclic antidepressants do not help to improve pain.
Opioids Examples include tramadol, hydrocodone, hydromorphone, morphine, and oxycodone	A type of medicine to treat severe pain Warning: Opioids can have serious side effects, such as abuse, addiction, and overdose. Overdose can lead to death.	Tramadol helps to reduce pain in the short term (up to 4 months). Other opioids help a little to reduce pain in the short term (up to 4 months). Current research does not show that opioids work or are safe in the long term (longer than 4 months).

Type of Medicine

About the medicine:

Researchers found:

NSAIDs (nonsteroidal anti-inflammatory drugs)
Examples include celecoxib (Celebrex^®), diclofenac (Zorvolex^®), ibuprofen (Advil^®, Motrin^®), meloxicam (Mobic^®), naproxen (Aleve^®), and piroxicam (Feldene^®)

A type of medicine to reduce pain and swelling

NSAIDs help to reduce pain.

Antidepressants
SNRI (serotonin and norepinepherine reuptake inhibitor) antidepressants

Duloxetine (Cymbalta^®)

Tricyclic antidepressants

Examples include amitriptyline (no brand name), desipramine (Norpramin^®), imipramine (Tofranil^®), and nortriptyline (Aventyl^®, Pamelor^®)

A type of medicine made to treat depression but also sometimes used to treat pain

Note: Some antidepressants may help treat pain. Taking an antidepressant for low back pain does not mean that the problem is in your mind.

The SNRI antidepressant duloxetine (Cymbalta^®) helps a little to reduce pain and may help you return to your daily activities.
Tricyclic antidepressants do not help to improve pain.

Opioids
Examples include tramadol, hydrocodone, hydromorphone, morphine, and oxycodone

A type of medicine to treat severe pain

Warning: Opioids can have serious side effects, such as abuse, addiction, and overdose. Overdose can lead to death.

Tramadol helps to reduce pain in the short term (up to 4 months).
Other opioids help a little to reduce pain in the short term (up to 4 months).
Current research does not show that opioids work or are safe in the long term (longer than 4 months).

From: Noninvasive Treatments for Low Back Pain

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John M. Eisenberg Center for Clinical Decisions and Communications Science. Noninvasive Treatments for Low Back Pain: A Summary of the Research for Adults. 2016 Nov 15. In: Comparative Effectiveness Review Summary Guides for Consumers [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2005-. [Table, Medicines for Chronic Low Back Pain].
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