Medications

Summary

• Acetaminophen (Tylenol) on its own shows limited benefit for chronic low back pain — discuss alternatives with your doctor
• NSAIDs (ibuprofen, naproxen, etc.) provide modest relief — but pose GI, kidney, and heart risks, especially for older adults
• Duloxetine (Cymbalta) has moderate effectiveness — the only antidepressant approved for chronic low back pain
• Pregabalin and gabapentin may help with nerve-related pain — watch for dizziness and falls
• Long-term opioid use is not recommended — limited benefit with substantial risks
• Topical treatments are often the safest option for localized pain, especially for older adults
• No medication is a "magic pill" — the combination of exercise, education, and psychological approaches alongside medication is the approach supported by evidence