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

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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

Comparative Effectiveness Review Summary Guides for Consumers [Internet].

Rockville (MD): Agency for Healthcare Research and Quality (US); 2005-.

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