Do You Really Need Back Surgery? A Surgeon's Guide to Neck and Back Pain and How to Choose Your Treatment

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Table 1 - NSAIDS

Non-Steroidal Anti-Inflammatory Medications for Pain Relief

Class Name Chemical name Risks
Over-the-Counter NSAIDS
Aspirin acetyl salicylic acid BT, GI, KT, FO
Motrin ibuprofen BT, GI, KT
Alleve naproxen BT, GI, KT
Pain Reliever
Tylenol acetaminophen LT, KT
Prescription NSAIDS
Arthrotec diclofenac & misoprostol KT, BT, FO, CR
Clinoril sulindac GI, KT, BT
Daypro oxaprazosin GI, KT, BT
Indocin indomethacin GI, KT, BT
Orudis ketoprofen GI, KT, BT
Relafen nabumetone GI, KT, BT
Toradol ketorolac intravenous GI, KT, BT
Voltaren XR diclofenac GI, KT, BT, CR
Prescription NSAID Cox-2 Inhibitors
Vioxx rofecoxib GI, KT, LT, FO, CR
Celebrex celcoxib GI, KT, LT, FO, CR
Bextra valdecoxib GI, KT, LT, FO, CR
Table 1 - An overview listing of the various types of NSAIDs - the non-steroidal anti-inflammatory medications including their risks. They range from aspirin to vioxx to tylenol and have a very important role to play in management of neck and back pain.

All pain medications listed in the text and table of this site have side effects. In addition to those listed as special risks for each of these medications, there are serious but unusual side effects that occur rarely such as decreased production of blood cells by the body. All medications are risky for anyone who may be pregnant or who is breast feeding and require special attention before prescribing. With the exception of over-the-counter drugs, all of these medications should only be taken with a prescription for the patient and under the direction of a physician. Liver toxicity and kidney toxicity usually do not occur, but routine blood tests for signs of these problem are essential if they are taken on an ongoing basis.


(BT) – blood thinning; (FO) – fetal/obstetrical effects; (GI) – gastric irritation; (KT) – kidney toxicity; (LT) – liver toxicity; (CR) - possible cardiac effects. Cox-2 = cyclo-oxygenase 2 inhibitor – these generally cause less stomach irritation than other NSAIDS.
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Aaron Filler, MD, PhD Do You Really Need Back Surgery Spine illustrations Oxford University Press Spine Book table of contents
Back Pain Guide