Opioid Pain Relievers for Low Back Pain

Covers opioid pain relievers, also called opiates or narcotics, to treat low back pain. Lists generic and brand names such as codeine (Tylenol 3) and hydrocodone (Vicodin). Looks at why they are used and how well they work. Includes possible side effects.

Opioid Pain Relievers for Low Back Pain


Generic Name Brand Name
hydrocodone Norco, Vicodin
hydromorphone Dilaudid, Exalgo
morphine Astramorph
oxycodone OxyContin, Percocet
tramadol Ryzolt, Ultram

Opioids are also called opiates or narcotics.

Opioids are sometimes combined with other medicines. For example,
Percocet is oxycodone
combined with acetaminophen.

How It Works

Opioid pain relievers suppress your perception of pain and calm your emotional response to pain. These drugs reduce not only the number of pain signals sent by the nervous system but also the brain’s reaction to those pain signals.

Why It Is Used

Opioids are usually reserved for the treatment of severe short-term (acute) back or leg pain that has not responded to other medicines. Because opioids are potentially addictive, they are usually
prescribed only for 1 to 2 weeks.

Sometimes opioids are used for people who cannot take pain medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs) because they have conditions such as heart, kidney, or liver problems. Or opioids may be used for people who take other medicines that should not be combined with pain medicines.

How Well It Works

There is no clear evidence that opioids help either acute or chronic low back pain more than other treatments.footnote 1 They seem to help some people, but sometimes the amount of medicine
you need for relief causes side effects that make daily functioning difficult. Further study is needed.

Opioid pain relievers for chronic low back pain should only be
administered by health professionals with experience in chronic pain

Side Effects

All medicines have side effects. But many people don’t feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.
  • Signs of an overdose, including:
    • Cold, clammy skin.
    • Confusion.
    • Severe nervousness or restlessness.
    • Severe dizziness, drowsiness, or weakness.
    • Slow breathing.
    • Seizures.

Call your doctor if you have:

  • Hives.
  • A fast, slow, or pounding heartbeat.
  • Increased sweating.
  • Redness or flushing of the face.

Common side effects of this medicine include:

  • Constipation.
  • Dizziness, lightheadedness, or feeling faint.
  • Drowsiness.
  • Nausea or vomiting.

See Drug Reference for a full list of side effects. (Drug Reference
is not available in all systems.)

What To Think About

Opioid pain relievers are strong medicines. They can help you manage pain when you use them the right way. But if you misuse them, they can cause serious harm and even death. For these reasons, it is important to use them exactly as your doctor prescribes. But you can get addicted to opioids. The risk is higher if you have a history of substance use. Your doctor will monitor you closely for signs of misuse and addiction and to figure out when you no longer need to take opioids. If you are worried about addiction, talk with your doctor.

Opioids may be considered if other medicines and treatments have not controlled pain or are not safe for you. To make this decision, you and your doctor may consider:

Dry mouth is common with these medicines. To help with dry mouth, you can chew sugarless gum, suck on sugarless candy, or melt ice in your mouth. If you continue to have problems with dry mouth after a couple of weeks, call your doctor. Dry mouth can lead to tooth decay and gum disease.

Some of these medicines have acetaminophen in them. Check the labels on all the other nonprescription and prescription medicines you take. Many medicines have acetaminophen. Do not take two or more medicines with acetaminophen in them unless your doctor has told you to. Taking too much acetaminophen can be harmful. If you have questions about this, talk to your doctor or pharmacist.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don’t take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breastfeeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breastfeeding, or planning to get pregnant.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) ( What is a PDF document? ) to help you understand this medication.



  1. Chou R (2010). Low back pain (chronic), search date April 2009. Online version of BMJ Clinical Evidence: ://www.clinicalevidence.com.


ByHealthwise StaffPrimary Medical Reviewer William H. Blahd, Jr., MD, FACEP – Emergency Medicine E. Gregory Thompson, MD – Internal Medicine Adam Husney, MD – Family Medicine Kathleen Romito, MD – Family Medicine Specialist Medical Reviewer Kathleen Romito, MD – Family Medicine

Current as ofNovember 29, 2017