This episode is entitled “The best medication for lower back pain”. You will learn:

• The best medication is no medication
• How to work out whether to use medication for lower back pain
• When is the best time to use them
• How to use medication for lower back pain (if you must)

The best medication is no medication

The biological purpose of pain is an alarm system. If you mute it by taking painkillers, you’re missing an opportunity to learn from your pain. For the majority of lower back pain sufferers medication does little good. If it lulls you into the false sense of security that you can carry on doing things that would otherwise be painful, it’s entirely counter productive. If you have recent onset lower back pain, I would advocate for not using medication, if you can manage without it. Pain is there to warn you not to do something. It’s there to teach you, so back off and try not to do the things that hurt.

Very few medications benefit you in the long run. Opiates are an absolute classic. The longer you take them for, the less effective they become. After the first six weeks, they pretty much are ineffective for pain. You should not be taking those kinds of drugs long-term. A lot of medications, pills, drugs, become less effective the longer you take them. The more you take a pill, the more your body gets used to it, the less effective it becomes and the more you have to take in order to get the same effect. And although many of these pills may not be strictly speaking addictive. Although opiates definitely are. They effectively become that because you find that you get less benefit, you take more of them, and that is a form of addiction.

How to work out whether to use medication for lower back pain

There are circumstances in which you should use them. If you are struggling to sleep, there is a stronger argument for using painkilling medication, because sleep is super important, and without it, your pain tends to feel worse. People who are sleep deprived experience pain more profoundly and are just be fatigued and less able to cope.

When is the best time to use them

The best time is almost certainly when you need to get some sleep. If you’re struggling to sleep, take some painkillers in order to help you get to sleep, but don’t get used to using them in order to try and carry on life as close to normal.

How to use medication for lower back pain (if you must)

Use them selectively. Start with your paracetamol or acetaminophen if you’re in the States. I think Tylenol is the main brand there. Then move off this ladder depending on how you respond. Use them at night if you’re struggling to sleep, but don’t use them in order to mask the pain and carry on doing the things that would otherwise be painful, particularly if you have recent onset pain, because the pain could signify a barrier. Don’t go past that or you will stop healing from taking place.

The biological purpose of pain is an alarm system. If you take painkillers to suppress pain, there is a possibility that you are holding up the rate of healing and prolonging your problem, and possibly even making it worse. The classic is sportsman who use analgesia in order to carry on doing the sport, but they’re actually doing further damage to the related tissue that’s causing the pain.

Don’t use any medication for lower back pain if you don’t have to. If you really do, then nighttime in order to get the decent sleep is probably a sensible time to use them. Don’t just use them on an ongoing basis and get someone to help you to understand exactly what the cause of your pain is. If you’re not addressing the cause you’re only treating the symptom. Prevention is better than cure.