Pain Medication Side Effects

Side effects are the unplanned consequences of having taken a drug. Usually, a side effect is unwanted, such as an allergic reaction. Side effects can occur outside of or away from the area for which the drug is intended. If you take NSAIDs or aspirin long-term for spinal arthritis, you may already be familiar with one well-touted side effect: Stomach ulcers and/or bleeding of the stomach lining.

Quite often, but not always, side effects are not serious, and go away on their own.

Woman wearing a head scarf holding a pill bottle and taking a pill
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Side Effects and Pain Relief — a Trade-Off?

The value of knowing the side effects of neck or back pain medications is that it enables you to make informed choices. This is called weighing the risk to benefit ratio.

Admittedly, the decision can be like trading one problem for another. In the example above, which is worth more to you — long-term relief from arthritis pain, or keeping your stomach free of ulcers and your stomach lining intact? You and your doctor are in the best position to decide that, and it’s highly likely your doctor can provide you with useful information that may help you figure out what to do.

How to Find Side Effects of Drugs You're Considering

When taking over the counter drugs, you can read the label for side effects, then weigh these possibilities against the pain relief benefit you expect to get from taking the medicine. Ask the pharmacist and/or your doctor about anything you don't understand. Note that some side effects constitute a medical emergency; an example is having an allergic reaction to the drug.

If your doctor prescribes medication, you should be able to have the risk/benefit conversation with her. In many cases, you can also look up the medication’s side effects on a quality site like which may assist you in thinking things over before making that final decision.

Along with other information about the medication, will list the most common, less common and rare side effects of the drug. If you have questions about what you read, consult your doctor or pharmacist.

Are the Risks of Opioids Worth It?

One class of drugs that merits special risk to benefit consideration is opioids. Like all pain medications, opioids come with side effects, the most common of which include: Constipation, nausea, sedation, and increased risk of falls and fractures in the short term and depression and/or sexual dysfunction in the long term.

But as narcotics, opioids also come with the risk of addiction. This could change your life in a big way — and not for the better.

So are taking opioids worth the risk of becoming a drug addict? A 2015 review by Deyo and associates entitled "Opioids for low back pain" and published in The BMJ reports while opioids are the most commonly prescribed painkillers in the U.S., (with more than half of regular opioid users experiencing back pain), they don’t seem to help people return to work any faster, nor do they improve functioning when used for an acute episode.

As far as chronic back pain goes, Deyo reports that reviews of medical literature found “scant evidence” that opioids are effective. He reports that for all types of non-cancer pain — which, of course, includes, but is not limited to neck and back pain — the effectiveness of opioids is about 30%. This across the board measurement tends to play out as short-term pain relief. Improvements in the ability to physically function are less clear, he says.

The CDC recommends that doctors not start their back or neck pain patients with opioids when they first come for treatment. Instead, they say "opioids should be used only when benefits for pain and function are expected to outweigh risks."

Side Effects Comparisons

Here are a few examples of common back pain medications and some of the common, and rarest associated side effects. Note: this chart is just to help get you oriented to weighing the risks to benefits of pain medications. It does not include all the information you need to make a decision. For that, talk to your doctor and pharmacist.

Active Ingredient Brand Name Drug Class OTC or Prescribed? Either Most or Less Common Rarest
Naproxen Aleve NSAID Both (MOST) Belching, bruising, difficult or labored breathing Anxiety, back or leg pains, bleeding gums, blindness
Acetaminophen Tylenol Analgesic (pain reliever) Both   Bloody or black, tarry stools, bloody or cloudy urine, fever
Pregabalin Lyrica Anticonvulsant Prescribed (off-label) (LESS) Difficult or labored breathing, shortness of breath, tightness in the chest Blistering, peeling, or loosening of the skin, chills, cough, diarrhea, difficulty with swallowing
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