“New guidelines, several meta-analyses and a few new studies show that neither medication nor nonpharmacologic approaches confer much benefit” (JWatch.org jan 2018)
A few studies have been done on Gabapentin and Pregabalin for back pain with radicular pain and not been found to have any effect. One study with Pregabalin titrated to 600mg and continued for 8 weeks was ineffective. It had the same effect as “sugar” pills.
Six studies of gabapentin versus placebo or pregabalin against another analgesic in pat. with LBP (about 500 pat) showed no clinically meaningful benefits and substantial side effects.
Diazepam as extra medication in 114 pat. w LBP who were given naproxen did not improve pain or function at 1 week.
NSAIDS (ex. naproxen, ibuprofen) have also been in the storm of questioning their effect and shown to have only modest effect in LBP w/wo radicular pain. One would need to treat 6 patients for 1 to have benefit.
Nonpharmacological treatments:
1. intradiscal steroids in pat. w MRI evidence of vertebral endplate inflammation: after 1 mo some improvement, after 3 mo worse, after 12 mo no difference.
2. Radiofrequency denervation for pat. w pain from facet joints, SI joints or intervert discs showed no incremental benefit when added to typical exercise therapy.
3. Spinal manipulation a meta analysis of 26 randomised trials for acute LBP showed statistically significant but modest benefit að 6 weeks with a high frequency of moderate side effects.
So: drugs dont work, injections and denervations dont work, manipulation seems to help a little bit but you pay a considerable sum of money and waste time doing repeated manipulations.
It may be considered a relief that you dont need to take any medication, you dont need to go to the doctor, physiotherapist or chiropractor, you just wait for a few weeks knowing that there is sound reason to expect spontaneous recovery.
If the back pain is chronic, which indeed is a very common condition; medication with pain medication is not advisable as the risk of addiction is considerable and the effect is small according to research.
Note: these are not to be considered guidelines for every back pain situation!