Back Pain and Spine Physicians in Colorado
Telephone: (303) 762-0808
Fax: (303) 762-9292

Nonoperative Treatment Options: Medications

Back and neck pain can be miserable! Injury, herniated disc, spinal stenosis, osteoarthritis, vertebral compression fracture: even a simple back sprain can cause life-altering pain. Back pain is one of the most common reasons people seek medical care.

In our practice, we recommend and prescribe medication to patients who are under our care. We understand spinal disorders can be painful and want to help you manage your pain during treatment that may include physical therapy. Patients who undergo spinal surgery will receive proper medications needed after their procedure and during recovery.

Yesterday vs. Today
Years ago patients with back pain were told to get off their feet and stay in bed for a week. After much scientific study, it was proven that inactivity does little to conquer back pain. Instead, pain control and physical therapy helps patients to get back on their feet. Physical therapy teaches patients how to be flexible and strong, while learning about proper posture, biomechanics, and back pain prevention.

Medication - Overview
Listed below are common types of drugs prescribed or recommended and available over-the-counter (OTC) to treat symptoms. Sometimes, drugs are combined such as an NSAID and muscle relaxant. Your doctor will explain what can and cannot be combined, as well as other information about drugs to treat your particular problem.

Type Purpose
Narcotics (Opioids) Short-term acute pain control
Muscle relaxants

Relieve muscle spasms and cramping


Reduce inflammation and pain

Sedatives Promote sleep
Transdermal analgesics Pain control delivered through a patch

*Non-steroidal anti-inflammatory drugs

Narcotics (Opioids)
Narcotics are used for a short time to control acute pain. Acute pain is sometimes described as severe and sharp. Narcotics taken for a long time may cause your body to develop a drug tolerance, meaning it takes a larger dose to control pain.

Table 1: Opioid Analgesics: Class II

Brand Name Generic Name/Component(s)
MS Contin® Duramorph
Dilaudid® Hydromorphone
Levo-Dromoran® Levorphanol
Demerol® Meperidine
Dolophine® Methadone
OxyContin® Oxycodone
Numorphan® Oxymorphone

Table 2: Opioid Analgesics: Class III & IV

Brand Name Generic Name/Component(s)
Lortab® Acetaminophen, hydrocodone
Vicodin® ES Hydrocodone bitartrate, acetaminophen
Tylenol® with Codeine Acetaminophen, codeine
Fioricet® with Codeine Butalbital, acetaminophen, codeine
Fiorinal® with Codeine Butalbital, acetaminophen, codeine
Soma® with Codeine Carisoprodol
Synalgos-DC® Dihyrocodeine bitartrate
Darvon® Propoxyphene
Darvocet® Propoxyphene
Wygesic® Propoxyphene, acetaminophen
Talacen® Pentazocine, acetaminophen
Talwin NX® Pentazocine, naloxone

Table 3: Neuropathic Pain Control

Brand Name Generic Name/Component(s)
Neurontin® Gabapentin

Muscle Relaxants
Muscle relaxants help relieve muscle tightness, spasms, and cramping. Acting on the central nervous system, these drugs cause a relaxing effect in muscles.

Table 4: Muscle Relaxants

Brand Name Generic Name/Component(s)
Soma® Carisoprodol
Soma® Compound Carisoprodol, aspirin
Soma® Compound with Codeine Carisoprodol, aspirin, codeine
Flexeril® Cycobenzaprine
Parafon forte® Chlorzoxazone
Skelaxin® Metaxolone
Robaxin® Methocarbamol
Robaxisal® Methocarbamol, aspirin
Norflex® Orphenadrine
Norgesic® Orphenadrine, aspirin, caffeine

Non-steroidal Anti-Inflammatory Drugs (NSAIDs)
Many spinal disorders cause soft tissue inflammation. A herniated disc can cause spinal nerve inflammation and pain. Whiplash or overuse injuries also affect soft tissues and cause swelling and muscle pain. Non-steroid anti-inflammatory drugs help reduce inflammation and pain.

Table 5: Non-Steroidal Anti-Inflammatory Drugs

Brand Name Generic Name/Component(s)
Celebrex® Celecoxib
Aspirin® Salicylate
Trilisate® Choline magnesium trisalicylate
Cataflam® Dicofenac
Clinoril® Suldinac
Disalacid® Salsalate
Dolobid® Difunisal
Duexis® Ibuprofen/Famotidine
Feldene® Piroxicam
Indocin® Indomethacin
Lodine® Etodalac
Motrin® Ibuprofen
Nalfon® Fenoprofen calcium
Naprosyn® Naproxen
Orudis® Ketoprofen
Anaprox® Naproxen sodium
Toradol® Ketorolac
Tolectin® Tolmetin
Vimovo® Naproxen/Esomeprazole

Back or neck pain can make getting to and staying sleep difficult. Your doctor understands this and may prescribe a sedative to help you sleep. These drugs should not be taken long-term, as they can be habit-forming.

Table 6: Sedatives

Brand Name Generic Name/Component(s)
Valium® Diazepam
Valrelease® Diazepam
Xanax® Alprazolam
Ambien® Zolpidem tartrate
Restoril® Tamazepam
Dalmane® Flurazepam
Sonata® Zaleplon

Transdermal Analgesics
Certain pain-relieving drugs are available in transdermal patch form. The drug is delivered over time through the skin. Transdermal patches help some patients avoid the gastrointestinal consequences of oral medication.

Table 7: Topical Analgesics

Brand Name Generic Name/Component(s)
Lidoderm® patch Lidocaine
Duragesic® patch Fentanyl
EMLA® Cream Lidocaine, prilocaine
Capsaicin Cream Capsaicin
Zonalon™ Doxepin HCI

Side Effects
Whether your medication is prescribed (Rx) or over-the-counter (OTC), there are risks -- side effects, drug interactions, and liver damage. Therefore, be sure to tell you doctor about your allergies, current medications taken (Rx and OTC), and use of vitamins and herbs. When you obtain a new medication, take time to read the information provided by your pharmacist or on the label.

There are certain side effects you should immediately report to your doctor. Such as:

Black, tarry stool Hives, skin rash, itching
Behavior changes Severe confusion or fatigue
Cold, clammy skin Severe weakness
Hallucinations Trouble breathing
Facial swelling Trouble urinating
Fast or slow heartbeat Yellowing of skin or eyes

Our practice is committed to helping our patients relieve pain and symptoms while under our care. We carefully and thoroughly assess your condition and treatment progress so the medications prescribed or recommended help you as you quickly and safely recover.

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