New research raises concerns about certain prescription pain treatments. Here’s what workers and families should know about common pain relievers, their risks and other ways to find relief.
Your back hurts after a long shift. Maybe you spent the day, cleaning rooms, caring for patients or working on a construction site.
You still have bills to pay and another workday ahead. So you reach for something to ease the pain.
But which treatment is safest?
A new study published October 19 in JAMA Network Open raises important questions about how lower-back pain is treated, particularly when prescription opioids are involved.
The findings also offer a reason to look more closely at everyday painkillers, including ibuprofen, naproxen and acetaminophen.
These medicines can help, but each comes with risks. And the strongest treatment isn’t necessarily the best choice for every patient.
Researchers examined Medicaid records for nearly 400,000 adults receiving treatment for sudden or recently developed lower-back pain.
None had recently used opioids when they entered the study.
Over 13 months, the estimated cumulative incidence of an opioid use disorder or overdose diagnosis was approximately 2%.
Patients who started treatment with higher-dose prescription opioids had the greatest relative risk of those outcomes.
Longer prescriptions for lower-dose opioids were also associated with increased risk.
Meanwhile, people receiving chiropractic care or physical therapy had lower rates of opioid-related diagnoses.
The researchers found that chiropractic treatment was associated with a roughly 33% lower relative risk and physical therapy with a 31% lower relative risk.
The study does not prove that chiropractic care or physical therapy prevents opioid addiction.
Researchers examined existing medical records. Patients receiving different treatments may have differed in pain severity, access to care or other health conditions.
The findings support considering non-drug treatments early, but they do not establish which treatment is safest for every individual.
What about ibuprofen, Aleve and Tylenol?
For many people, treatment begins at a pharmacy rather than a doctor’s office.
Three familiar options work differently.
Ibuprofen, sold under brands including Advil and Motrin, reduces pain and inflammation.
Naproxen, sold as Aleve, also reduces pain and inflammation and generally lasts longer.
Both belong to a group of medicines called nonsteroidal anti-inflammatory drugs, or NSAIDs.
They can provide short-term relief, but the Food and Drug Administration warns that NSAIDs can cause stomach bleeding and kidney problems. They also carry cardiovascular risks, particularly with excessive or prolonged use.
People with kidney disease, high blood pressure, stomach ulcers or certain other conditions should ask a healthcare professional before using them.
Acetaminophen, commonly sold as Tylenol, relieves pain but does not reduce inflammation in the same way.
Its major danger is liver damage when someone takes too much, sometimes accidentally by combining products containing the same ingredient.
None of these medicines should be taken beyond the label directions without medical guidance.
And the JAMA study did not comprehensively measure painkillers purchased without prescriptions. Its findings cannot tell us which over-the-counter medicine carries the lowest opioid-addiction risk.
Could common painkillers make back pain last longer?
There’s another question worth considering.
That research raised questions about whether suppressing inflammation early might be associated with persistent pain.
But it did not establish that taking ibuprofen or naproxen causes chronic back pain.
Current clinical guidance still recognizes NSAIDs as an option for short-term relief when appropriate.
The practical lesson isn’t to avoid every painkiller. It’s to understand what you’re taking, follow the directions and seek advice if you need medication repeatedly just to get through the day.
Why this important for workers and Latino families
Back pain can be especially difficult when earning a paycheck depends on physical work.
Construction, agriculture, cleaning, warehouse jobs and caregiving can involve repeated lifting, bending or long hours standing.
Many Latino workers are employed in these industries, although the risks vary by job and working conditions.
For someone who cannot easily miss a shift, buying pain medicine may seem more practical than scheduling an appointment or taking time off.
But treating pain without understanding its cause can delay needed care.
The new study included more than 72,000 patients identified as Hispanic. However, it did not establish that the treatments had different effects for Latino patients.
Its findings are relevant to families making treatment decisions, not evidence of a Latino-specific medical risk.
What can help without medication?
The CDC recommends considering nonopioid treatments for many cases of acute lower-back pain.
Depending on the cause and severity, options include heat, gentle movement, appropriate exercise, massage, physical therapy or spinal manipulation.
Staying reasonably active often helps more than prolonged bed rest, although painful activities may need temporary modification.
Physical therapy or chiropractic care may not be affordable or accessible to everyone. Insurance coverage, transportation and time away from work can affect the choices patients have.
And not every treatment is appropriate for every injury.
When should you get medical help?
Most uncomplicated lower-back pain improves over time. But some symptoms should not wait.
Seek emergency medical care if back pain comes with new loss of bladder or bowel control, numbness around the groin or anus, or serious or worsening leg weakness.
Pain after a major injury, pain with fever, or pain that is rapidly worsening also needs prompt medical assessment.
Before buying another bottle of pain medicine, check the active ingredients. Avoid doubling up on similar products, and ask a pharmacist about possible interactions with medications you already take.
If the pain continues, keeps returning or makes it difficult to work, talk with a healthcare professional about treatment options.
The goal isn’t simply to get through another shift. It’s to relieve the pain without creating another health problem.
