Common Painkillers Don’t Work for Back Pain, Study Says

Common Painkillers Don’t Work for Back Pain, Study Says

By Staff

Common painkillers used for back pain simply do not work for most people, says a study published in the Annals of the Rheumatic Diseases.

Non-steroidal anti-inflammatory drugs (NSAID) like aspirin, Aleve and Advil, only provide one-in-six patients with back pain any significant reduction in pain.  And, as is well documented, these painkillers come with gastrointestinal side effects.

The study from The George Institute for Global Health questioned the effectiveness of existing medicines for treating back pain. Earlier research has already demonstrated paracetamol is ineffective.

The researchers, which examined 35 trials involving more than 6,000 people, also found patients taking anti-inflammatories were 2.5 times more likely to suffer from stomach ulcers and bleeding.

Lead author Associate Professor Manuela Ferreira says the study highlights an urgent need to develop new therapies to treat back pain and reduce side effects.

“Back pain is the leading cause of disability worldwide and is commonly managed by prescribing medicines such as anti-inflammatories.  But our results show anti-inflammatory drugs actually only provide very limited short term pain relief. They do reduce the level of pain, but only very slightly, and arguably not of any clinical significance,” said Prof. Ferreira.

“When you factor in the side effects which are very common, it becomes clear that these drugs are not the answer to providing pain relief to the many millions of Australians who suffer from this debilitating condition every year,” he added.

Research Fellow Gustavo Machado, of The George Institute and the School of Medicine at the University of Sydney, said, “Millions of Australians are taking drugs that not only don’t work very well, they’re causing harm. We need treatments that will actually provide substantial relief of these people’s symptoms.

“Better still we need a stronger focus on preventing back pain in the first place. We know that education and exercise programs can substantially reduce the risk of developing low back pain.”

Most clinical guidelines currently recommend NSAIDs as the second line analgesics after paracetamol, with opioids coming at third choice.

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Authored by: Staff

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Shauna H.

“All the protocols put in place in the last two years, Rx data base, UDT, pill counts are working to rid the pain management professional of the people that sought to abuse the system.
I look for things to improve as stress in removed from the doctors that help us.
The media, and lack of accuracy in media and no accountability for articles, talk shows and other forms of communication are responsible.”

Excellent point that actually gives me hope! You are 100% right saying all the steps that we compliant pain patients do are actually helping our physicians, and physicians in general that prescribe opioids for chronic pain.

I am more than willing to go through such needed steps to stay compliant in my doctors eyes, and they have just a few tests to go by. A UDS, a pain agreement and a physician’s trained eye to weed out the ‘users that are abusers’. They have made it harder for us true pain sufferers to get, stay on, and responsibly use our medications.

You mention the media and talk shows. I have a personal problem with Dr. Drew Pinsky who is the first to comment on any loss of life concerning opioids. Obviously if a patient (or a self-medicating person) has mixed benzodiazepines with opiates IN EXTREME DOSES and dies, this is not a surprise. On a CNN ‘town hall’ he was addressed by a woman who was a chronic pain patient. I thought she sounded out of it. But they allowed ONE actual chronic pain patient to speak and it was not fair.

Fairness in standing up to the media and the well known personalities on TV is an absolute joke. The rest of the show was dedicated to the **incorrect** statistics often used.

And I thought I’d get something out of that town hall meeting. What a joke. Thanks CNN for giving us a panel who is obviously biased and had no voice for those compliant patients who cannot have a quality of life without prescribed pain medication. When is the ladder going to lean towards us so we can get our story out, aside from comments on articles??

**Feeling frustrated**

Tim Mason

Shauna see this article.

The Rx opioid epidemic is a hoax. Even a top CDC official admitted that they had overstated the problem.
They realized that they had grouped heroin users into the same group as chronic pain patients,
The CDC statistics were grossly flawed by their own admission.
In fact, further investigation reveled that chronic pain patients have comorbidities related to age that affect the mortality rate of the number 1 aliment in America - Pain.
All the protocols put in place in the last two years, Rx data base, UDT, pill counts are working to rid the pain management professional of the people that sought to abuse the system.
I look for things to improve as stress in removed from the doctors that help us.
The media, and lack of accuracy in media and no accountability for articles, talk shows and other forms of communication are responsible.
Be Well,
Tim Mason

Shauna H.

I am 58 and at 16 was in a horrible rollover accident in the back of a van unrestrained and tumbled like a shoe in a dryer. Worked as a nurse until my Thoracic spine fell apart and the open back surgeries began. My back was never the same.

I have an Intrathecal pain pump that has taken the bulk of my pain away. It’s the best thing I’ve ever done. Yes it’s a commitment with refills every 2-3 months but I suffered for 20 years taking oral meds and had every procedure possible. Taking Ibuprofen is a no no for my sliding hiatal hernia even though I take it for headaches, etc. My pain Dr who is a respected Anesthesiologist who implanted my pump also prescribes breakthrough medication which does happen with a pump especially before a refill when the efficacy lowers. Today I had an appt and filled out a new pain agreement, gave a urine sample and brought a note from another doctor showing reduction in a medication for PTSD from a domestic violence relationship. I do everything they ask, so far no problems. There were new signs up on practically every wall stating ‘physicians’ could lose their license if medication is diverted or abused. They are facing such pressure from everywhere and everyone I’m wondering how long Pain docs are going to stay in practice. A true shame. We patients who never asked for this ongoing pain are overwhelmingly compliant and just want to live a life that has some quality. I had to sell my house when I could no longer care for it before the pump came 6 years later. Pain can make our life decisions and people without it just can’t comprehend what we experience. I did feel cared for today in an honest and forthcoming discussion with my doctor.

I couldn’t go on if my 3 a day breakthrough meds were taken from me. They are part of my pain management-period. That, my friends is a reality no one wants to believe-that we are fine taking NSAIDS and APAP. I didn’t ask to be thrown violently around in an accident. I hope the CDC ‘people’ never experience what we have.
Then again, it may open their eyes to what chronic pain patients live with 24/7.
I also use Lidocaine patches which are very effective (forgot to say). We keep open minds and try practically everything. No one has the right to dictate my medical care or the relationship between my doctor and I.

Tim Mason

John your attorney is correct and Bill Mayer better believe in KARMA. Pain is an enigma and only those that have real chronic, night waking, painful walking type of pain can understand it. Bill Mayer is like the embalmer that works at a funeral home that said “I know what it is like to be dead! I work at a funeral home”
I am 60 myself. When you start taking pain medication away from old people that is considered a form of “Elder Abuse”
Bill will grow up one day and change his name to William.
Laughter is the best medicine. Laugh at him.

Tim Mason

We have excellent pain management doctors here in Tennessee. The living is cheap and the winters are very mild. Chattanooga Tn is a great City to live and retire. Lots to do as well.

I’m 58 and a lot of my research and reading is calling ” Baby Boomer Generation ” the worst offenders for Opiate abuse.

My new PM doctor is following the CDC guidelines to the letter. After 3 visits now I have caught her in a lie during each visit. The last was - Pa. Work Comp is requiring all Comp patients to be weaned off Opiates. In some cases she told me the Insurance carrier gave the Dr 30 days to wean the patient off completely,

I sent my Attorney of 31 years a ( Comp Super Attorney) by state definition - an email repeating what the Dr told me. My Attorney simply responded ” that’s a lie & probably a crime ” he said ” you can’t treat patients like that unless the Dr and the patient both agree to the reduction in meds.

Another note ; Bill Maher tweeted after the Super Bowl was over - ” Does any REAL AMERICAN have an OxyContin for me ” Last year was his famous rant about the Opiate Induced Constipation - saying Now we have a pill so drug addicts can poop.

Seems like anyone using any controlled pain meds are addicts now & the media has done most of the damage by convincing the public Pain Patients are all addicted to their pain meds.


John S

Tootie Welker

Thx for your comments Tim. I was tried on a fentanyl patch before I had my first fusion and it made me sicker than a dog! I’ve had fentanyl in hospital after surgeries and been fine but the patch made me barf! And the problem is I go to the low income clinic in Missoula and they put their high end dose BELOW the CDC guidelines and require you to go to one of our two pain clinics who basically only want to do invasive techniques. I spoke to a friend about one of the docs at the pain clinic that I had a very bad experience with and she was “oh, he prescribes me pain meds”. I was surprised so asked her how much. Her response was I asked for acute pain not chronic and he gives me 12 pills a month!!! I didn’t ask what kind/strength but that would be about 2 days for me. Once I get my SSDI approved I’d like to move to a climate that doesn’t have such long winters but I’m afraid I won’t be able to find any treatment for my pain. I really would like to travel too but same fear. Even though I am given 3 written scripts each appointment, am I going to be able to fill outside of Montana? I feel like I have a leash with a choke chain on…

Tim Mason

Common “pain killers” do work for common back ache. It’s on the label. Common pain killers do not work for “uncommon” back pain. The label on common pain killers states “for occasional use only” if pain persists, see a physician. Taking more than the recommended dosage is risky All drugs have risks, even OTC drugs.
Uncommon or prolonged pain requires medical attention.
I used common medications when I was younger, but now at 59, pain lingers and lingers. Three surgeries later my pain requires stronger medication indicated by medical imaging and other diagnostic tests.
People posting here do not suffer from common pain or common back pain or common ailments. I think most of us are of advanced age.
With all due respect of the author(s) of this thread, the title is misleading and a bit intimidating.
After seeing all the comments, I was compelled to comment again.

Tim Mason

Tootie you should probably be switched from morphine to a fentanyl patch That worked for me like a champ. The better drug was Nucynta but it caused me to have a headache.I had ZERO pain with 100 mg extended release Nucynta. After being on the Nucynta for a week and a half I called and reported the headache. I was back in the clinic in two days and switched to the patches. I was up to 90 mg MS continuous release per day.
Although it is said that asking for a particular drug will make one look like a drug seeker it could be worth a try. I am 59 so no need to worry about any addiction. All drug have risks, even over the counter stuff. Good luck.


William Dorn, Have you ever heard the old saying “you can’t fight city hall”? Well fighting a government agency that has such big money behind it is much, MUCH harder!

William Dorn

Why are the pain groups not demanding the cdc withdraw there gutdlines.


NDAIDS are wickedly dangerous drugs yet for the most part are OTC or readily prescribed. Most people think that when NSAIDS are used topically they are safe but this isn’t true. After tearing up my stomach on ibuprophen I shouldn’t be taking any but I take mobic for chronic chest wall pain. When trying to find a workable solution to reduced opiates my doctor ordered a formulary cream that contains mobic and the pharmacist filled it, mailed it to me THEN called to tell me that I couldn’t use it because I was already taking mobic! He said not to use any NSAID with the cream as it would be very hard on my stomach! It’s totally ludicrous that I can get NDAIDS any time and any where even though they are dangerous and their effectiveness is limited but the much safer and MUCH MORE EFFECTIVE opiates that I have safely used for years are suddenly being taken away! This just doesn’t compute!

Jean Price : I think its common knowledge that NSAIDS do harm and have little or no real pain relieving qualities after just a few days. Ask any chronic pain patient that has been forced on NSAIDS and they can and will tell you - I feel worse and my stomach hurts. We didn’t need a study to tell us NSAIDS are for quick work for inflammation caused by trauma or infection, like a tooth ache. Its when Dr’s keep patients on these drugs for long term use with no relief only to be told - give them a chance ! Give them a chance to do what ? Yes there are many NSAIDS on the market but are we to spend 3 months on each one only to find that we are in liver or kidney failure or we no longer have a useable stomach. Again, poor medical practice is not the answer and never will be.

As for Tylenol mixed with small doses of Opiates: it makes a good filler and fever reducer. The other reason was to limit a persons intake of these drugs knowing that the Tylenol will kill you if you take all 30 of them. Not long ago Tylenol was the number 1 choice for people that wanted to use an OTC drug to commit suicide. Percodan had aspirin in it and I always felt that it worked a little better at first even though it had less Oxycodone; 4.5 mg vs 5 mg in Percocet with Tylenol. Darvocet had 750 mg of Tylenol per tablet, now there’s a recipe for ill health. I think it was taken off the market in the U S but I’m not sure.

The anti - Opiate campaign is AGENDA driven by greed and money, NOT for the good of pain patients or to stem the tide of over dose deaths - as they continue to rise but not as a result of Prescribed Pain medication. ( in my opinion ).


John S

People in pain have known this for a long, long time, but no one would believe us.

Going back to 1987 after my 3rd back operation that yielded no relief I was put on Motrin 1200 mg 4 times a day. After a month I was rushed to the hospital complaining of chest pain. All the usual tests were done and they could find no issues with my heart, I was given a stress test to be sure. The doctor told me that I had the heart of an athlete and the pain was more than likely coming from somewhere else, he ordered an upper and lower G I test.

After the G I test I was told I had a Duodenal Ulcer and after a review of my medication I was told the likely cause was the high dose of Motrin - 1200 mg 4 times a day was not considered a high dose in 1987.

After a 5th operation I went back to the Cleveland Clinic complaining of increased pain and with no hesitation I was told ” you need to be on Motrin for a few months “. That was after I told the doctor about the ulcer, his solution was to put me on Tagamet. That’s like starting a fire and then throw water on it so you can start the fire up again. What kind of medical practice is that ?

NSAIDS are good for a few days to a week if tolerated but any longer than a week is asking for trouble ( in my opinion ) !

Tylenol, according to a Swiss study done in 2016 was shown to have little or no pain relieving qualities except for fever related pain and mild headache.

Opiates are the Gold Standard for Acute pain relief yet when the side effects are voiced to the public the worst they can come up with is constipation. Addiction comes from the improper use of Opiates and the improper use of most medications can be very dangerous.

We have become a society motivated by fear and knee jerk reactions no matter what the outcome is for the patient. Now even those patients in the most severe pain are told to ” Just suck it up, its for your own good “. That might be fine for mild pain but not for a patient that suffers day in and day out with severe, acute and chronic pain.

When will they admit to their mistake ?


John S

bert espinoza

Very true!!.
These drugs,only cause,hardships,like bleeding of ulcers,liver damage,and intestinal cramps,pain etc


Tim Mason,

I was on Celebrex for about a year for my chronic back pain around 2000 or so. I complained to my doctor I was not getting any relief and was experiencing stomach problems. He brushed off my complaints and perhaps did not believe me and told me to stick with it a bit longer.

So I took his word for it and kept on taking it until I started to vomit a few times a week. Went for a upper GI and the Celebrex eroded my stomach lining and caused a hiatal hernia. The doctor finally agreed Celebrex was not a good choice for me…….

My stomach has gotten better since then but I still can not take muscle relaxants and many other medications to this day. That said I am happy that MMJ is available now. Even though it does not help with my neuropathic pain but it does help with spasms and sleep at night and for that I am grateful.

Tootie Welker

I’ve had 4 back surgeries and am fused from L2-S1 and both SI joints. I have Ehlers Danlos hypermobility. After a year from my L4-S1 fusion I did have pain relief. Was able to wean off the morphine and just take a norco once twice a day. But by 3 years after the pain came back. My L3 was collapsing and caused permanent nerve damage. This was at the beginning of the opioid hysteria and the pain clinic didn’t think I needed anything. Fortunately my neurosurgeon saw it different. 2 years later L2 went and I now have chronic pain that only opioids help to relieve. I get severe stomach aches with NSAIDS and ibuprofen increases my blood pressure which is typically low normal. Besides I get absolutely no pain relief. My cervical spine is the same tho no surgeries, yet. But I do get almost daily headaches and have to take horizontal breaks. I think the stress of having to constantly fight to get a half way decent dose actually increases my pain. It’s really irksome that at 60 they don’t seem to give me any credit for on my own asking for help to wean off the morphine when I felt I no longer needed it and didn’t want to keep taking, tho the docs at the time were more than willing to keep prescribing. Right now I tend to run out 3-4 days before next refill. I’m below the CDC guidelines and keep saying just one more a day would dramatically improve my quality of life! I’ve been on opioids pretty steady steady since 2003, gone thru 2 psych evals that both showed low risk to abuse, I’m an intermediate metabolizer (tho can’t get doc to understand significance or about the joint pain with EDS). What really scares me is I’d like to travel more but fear I’d have difficulty filling my scripts in other states. I get 3 scripts at a time and only have to see doc every 3 months. Sigh

Petra Klein

As a person with a lot of backpain , I tried many things. Because I did not wanted to ruin my stomach or my kidneys with Painkillers I remembert , that 30 Years ago in Germany at our Munich Univ, Hospital we used what we called Reizstromtherapie so I tryed that here with a Tensmachine and since I do that I am virtually painfree. When I feel that I am starting to get Pain again , I am using the Tensmachine for around 1 to 2 Days and it is gone. Also I got myself an Inversiontable to put my Body upside down everyday for some seconds. A combination of these two does the trick…..and n o more Painkillers.

Douglas Greenfield

Figures, of course opiates are the third choice and the one thing I actually get some relief from, choice #1 is probably “wishful thinking”, choice 2&3 have adverse effects and we are too busy finding cures for ED…….. sad

Jean Price

I’m a little surprise at the results they found…and I wonder if this was in fact a controlled study…or more like a survey! And what type of back pain qualified the participant? Acute or ongoing? From disease or injury? Back pain comes from so many different causes! The other thing I wondered was what medication(s) was prodominately studied… and most importantly…at what dose. If these people weren’t taking prescription strength, but rather over the counter strengths…and a varied or reduced daily amount…it’s little wonder their pain wasn’t helped….and the study then would have little significance! Something that always intrigued me in general about these medications….All anti inflammatory medications, (of the non steroid type) are extremely “PATIENT SPECIFIC” when it comes EFFECTIVENESS! Meaning one person could take six different types of anti inflammatories without any significant relief…and yet the seventh one could be almost as dramatic as a narcotic medication, as far as giving relief for moderate pain! (Each anti inflammatory has some chemical and molecular difference, yet most work by the same mechanism, that of inhibiting prostaglandins.). So unless a person tries several different varieties…they may not realize they actually could get some relief from this class of medications. (I do agree paracetamol, commonly known as acetaminophen or Tylenol to most of us…is NOT an effective pain reliever…WHY it is combined with some narcotics is beyond me! Especially since routine use over time can cause liver enzyme changes, and overdosing actually causes liver damage.) Another reason it surprises me this study didn’t find people who had at least a small reduction of back pains that….pain can be at least partially CAUSED by inflammation AND inflammation can CAUSE pain, plus delayed healing. So it would stand to reason just by reducing inflammation, pain would be reduced at least some. For those who have an acute back strains, even when they live with long term back issues, I would think these medications could be helpful at least for three to five days, even if narcotics were also needed. The routine practice for a simple injury…sprain, strain, pulled muscle, etc…used to be a prescription strength dose of an anti inflammatory, usually ibuprofen, three times a day for three to five days. Even when the initial pain subsides a little after 24 to 48 hours, the remaining inflammation could delay healing, so additional days were recommended.) So the anti inflammatory has dual purposes were pain is concerned! When I see studies like this, I wonder what the actual intent behind the study is…sometimes we can easily guess it’s about marketing a procedure or new treatment or a new medication. Yet this one seems to confuse me…unless they are suggesting bypassing the use of ANY anti inflammatory for ANY back pain…and moving right to narcotics! Which, with the current mindset, doesn’t seem likely! Or perhaps there is a whole new classifications of drugs pending development,….it could be just wishful thinking, and an attempt to state a good reason for more research on pain medication options.… Read more »

Ibin Aiken

I would agree that the best way to not have back pain is to “do nothing” in life. EVEN that, will not guarantee a back pain, free, life. Approximately 20,000 people a year perish from sustained use of “common painkillers”. This information as per an anesthesiologist that is also a pain management specialist that I personally know and respect. He also advised me that it was much safer and effective to proceed to opioid medication if the pain can not be sufficiently eased with physical therapy, alternative treatments, or surgery for chronic pain. Our physicians have been educated as to the treatment of back pain and if sufficient relief is not achieved, then it’s time to seek a pain or specifically a back pain specialist. I have been through the entire procedure with one “disc” surgery and a fusion surgery hoping to escape the use of ANY type medication. Instead, I have been treated with effective opioid medication for about 20 years. As recent as 6 months ago I had been extremely stable on the type and dosage of medication that I was prescribed for being placed in the “failed back surgery syndrome”. It doesn’t feel like a “syndrome”, I’m in severe pain……constantly! The severe constant pain keeps me awake at night, limits my movement, causes me to be “short” on patience times, causes a less than cheerful outlook for the future, and it simply hurts…..constantly. This WITH opioid medication. I took myself “down” from 160 mgs of medication to a total of 100 mgs of medication about 5 years ago for fear of requiring a larger dosage in the future. However the CDC recognizes the best way to treat my personal, individual chronic pain.without knowing my weight, what my need FOR opioid medication is, my personal metabolism, and all the other particulars of my personal health. It seems the “one shoe fits all”, or a certain dosage of opioid medication is sufficient for ALL chronic pain patients if, cancer is not a factor. There is a “conversion chart” also provided by the CDC to our doctors. It seems that 90 mgs of morphine sulfate “pills” is sufficient for ALL chronic pain patients. If a patient takes “oxycon” then the patient only needs possibly 10 mgs per day. The point is that the CDC’s conversion chart may indicate that 10 mgs of oxycon is the equivalent of 90 mgs of the morphine sulfate pills, and that is all you need! 20mgs of say methadone, as per the “conversion chart” is the equivalent of 90 mgs of morphine sulfate, and that is all the agency states that a chronic pain patient needs. It ALL boils down to a reduction in dosage for patients prescribed in excess of the equivalent of 90 mgs of morphine sulfate per day regardless of your individual condition. Enforced by the doctors possible license forfeiture if the new guideline and “conversion chart” is compromised by ANY amount by the doctor or specialist. Chronic pain patients are being… Read more »

Tim Mason

Celebrex prescribed for me in 2007 caused me to lose 55 lbs. I started passing dime sized blood clots then quarter sized ones then much larger ones. I thought I had cancer. An upper sigmoidoscopy showed a large ulcer in my stomach. The cause, Celebrex. I was on Carafate for 3 months and had to eat baby food for it heal.
The orthopedic surgeon that prescribed Celebrex for me assured me it was safe and he took it himself every day.


Discovering the cause of back pain in the US is the easy part. Prevention and proper treatment seems to be an issue that this country can’t figure out.
Here’s the first issue; Most back issues stem from injury, especially work related injuries. Safety in the workplace is sadly lacking in physically active employment. Back strains from improperly or over lifting, slip and fall accidents, and many other reasons happen far too often.
Government run safety organizations like OSHA have let businesses slide on too many infractions for unsafe work conditions. Or they don’t even inspect corporations unless called by a disgruntled employee.
Next, after work related injuries happen, Workman’s Comp insurers and the employers discourse against proper diagnosis by referring injured employees to certain doctors who are obviously paid to do minimal testing to keep costs down. The treatment these doctors recommend are cheap and minimal for the same reason. They bandaid the patients back together and get them back to work only to find out years later that chronic back problems start and the company and insurance company is no longer on the hook for medical costs.
Finally, after years of hard work and mild pain issues, disabling pain starts. Our doctors then try to treat our pain but are subject to too many government regulations and under so much scrutiny that we live with untreated or under treated chronic pain.


When I clicked on my email, I thought “Great, they’re opiod-bashing.” I thought this was going to be an agenda-driven outcome. Then, I saw that it only talked about NSAIDs, and I found myself nodding. I take mobic/meloxicam. I have a torn disc in my lumbar back and cervical spondylosis.

If I don’t take my mobic, the range of motion in my hips is greatly reduced to the point that I shuffle around as someone 30 years older than me would (I’m in my mid-30’s). My knees ache without it and my feet hurt. But my lower back seems to be about the same.

Tramadol DOES help my lower back pain. So do muscle relaxants and lidocaine patches. My TENS unit can help but is never a stand-alone treatment for me. Epsom salt soaks can help to a degree. My acupressure mat helps somewhat. A heating pad can help. I got a new mattress and I sleep with pillows around me. I pace my activities. I just did some t’ai chi and it’s relaxing and I feel it helps a bit.

If I had to chose just ONE of these treatments, I’d choose tramadol. It allows me to continue to work full-time. Each of these treatments help, but I could do ALL of them and still not see the benefit I see from Tramadol. Tramadol allows me to engage in some physical activity which will help me improve my health through weight loss. Thank goodness I can take tramadol and these other treatments in addition to tramadol give me a meaningful quality of life.

Joe Kramer

Please send copy of this to the CDC and Insurance companies . They have destroyed pain care in the USA. Every pain group should be joining together and demanding the CDC withdraw there guidlines.