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Pharmacological therapies for back and nerve pain

NSAIDs: Non-Steroidal Anti-Inflammatory Drugs

There is good evidence of benefit in the short term from NSAIDs for the treatment of back pain and nerve pain. There are several different types of drugs within this category, and some patients may respond differently depending upon which drug suits them best in terms of pain control and side effects. There are also some risks associated with long-term use.

Analgesics and Neuropathic Pain Medication

Simple analgesics in the form of paracetamol have not been shown to be helpful in controlled clinical trials. Neuropathic pain medication, such as amitriptyline, gabapentin, and pregabalin, may be of benefit in radiating nerve pain (pain that spreads down the arm or leg). They do not seem to be helpful for back pain.

Opiates: Weak and Strong Varieties

Weak opiates such as codeine may be combined with simple paracetamol, and some trials suggest that there could be benefit. Strong opiates should only be used under medical supervision, as the risk of harm is high (mostly risks of addiction and from side-effects).

Diazepam: Use and Risks

Diazepam is sometimes used for muscle spasm in acute low back pain. There are no quality clinical trials to support this use. The risk of harm is considered high.

EUROSPINE is a society of spine specialists of various disciplines with a large knowledge of spine pathologies. All well-known and accepted treatment modalities for spine pathologies are represented by the members of the society. However, the Society cannot accept any responsibility for the use of the information provided; the user and their health care professionals must retain responsibility for their health care management.

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