Back Pain Relief Products: Evidence-Based Treatments That Work

Written by Beth Holloway, RN, M.Ed
2021-06-24

Back pain really interferes with life, even if it is only for a few days. It makes it hard to function and hard to think of anything else, except, “My back really hurts, and I wish I could get some relief.”  

In fact, about 1 out of 4 people with back pain report that their daily activities are limited by pain. Relief is available! There are some excellent products that can reduce back pain.

Types of Back Pain Relief Products

There are many different types of products for back pain. Each type has many products. A person’s back pain symptoms and medical history should be considered when choosing products for back pain. 

There are 6 effective types of back pain relief products:

See our expert reviews for recommendations in each category or take our back pain quiz for a personalized plan created just for you.

Over-the-Counter (OTC) Products for Back Pain Relief

OTC products for back pain may be taken by mouth or applied to the skin. Some of the OTC products taken by mouth are in pill, tablet, or capsule form.

Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain and fever. 

If taken regularly, over a period of time, they can also lessen swelling or inflammation. They do this by stopping the body's ability to make a substance that causes pain, fever, and inflammation. Some people may be unable to take NSAIDs because they may cause gastrointestinal (GI) and kidney problems.

Ibuprofen & Naproxen Sodium

Ibuprofen and naproxen sodium are the generic names. The brand names of the medicines are also listed, however generic or store brand products are available.

  • Ibuprofen [pronounced ai·byoo·prow·fn]. Two brand name products are Advil and Motrin. Ibuprofen is short-acting, meaning its effects last only a short time. It can last 4 to 6 hours.

  • Naproxen sodium [pronounced nuh·praak·sn]. Aleve is a brand name product. Naproxen sodium is long-acting, which means its effects last a long time. It can last 12 hours.

Acetaminophen

Acetaminophen [pronounced uh·see·tuh·mi·nuh·fn]. Tylenol is a brand name product. Acetaminophen is an OTC pain reliever. It helps reduce pain and fever, but not swelling or inflammation. Acetaminophen lessens pain by changing the way the body senses pain. And, it lowers fevers by acting on the part of the brain that regulates body heat. At high doses, acetaminophen can damage the liver. Some people may not be able to take acetaminophen because of its effect on the liver.

Acetaminophen & Diphenhydramine

Acetaminophen/diphenhydramine [pronounced uh·see·tuh·mi·nuh·fn / dai·fuhn·hai·druh·meen]. Acetaminophen/diphenhydramine is helpful when back pain interferes with sleep. A brand name product is Tylenol PM. It has two active ingredients, the OTC pain reliever, acetaminophen, and a sleep aid. 

  • Acetaminophen is an OTC pain reliever. It helps reduce pain and fevers, but not swelling or inflammation. Acetaminophen lessens pain by changing the way the body senses pain. And, it lowers fevers by acting on the part of the brain that regulates body heat. At high doses, acetaminophen can damage the liver. Some people may not be able to take acetaminophen because of its effect on the liver.

  • Diphenhydramine is an antihistamine used to treat allergy symptoms, but it also causes drowsiness, which helps with sleep. It may be used when back pain interferes with a person’s sleep. Because it causes drowsiness, it must be used carefully.

Medical Devices for Back Pain Relief

There are different medical devices that can help lessen back pain. They work in different ways, but all of them may help relieve the pain. 

Heat Therapy

Heat therapy helps with healing by increasing blood flow to the area where it’s applied. It also helps muscles relax. It can be applied in several ways including a pack, disposable wrap, an electric pad, and a waist-belt pad. All forms of heat therapy should be used carefully to avoid burning the skin.

Studies have shown short-term relief from acute and subacute (lasting less than 3 months) low back pain with heat wrap therapy. When exercise is added to the heat wrap therapy there is even more of a benefit.

Cold Therapy

Cold therapy, such as an ice pack, decreases blood flow to the area where it’s applied. When present, it can help to lessen swelling or inflammation. An ice pack also has a numbing effect. Because ice applications can injure the skin and tissue, it should only be applied for up to 20 minutes at a time. 

Although there aren’t studies to support the use of cold therapy for back pain, based on the effects of cold treatment for other conditions, it may provide relief. This is especially true for recent injuries.

Transcutaneous Electrical Nerve Stimulation (TENS) Units

Transcutaneous means across the skin. So, a TENS unit acts on the nerves across the skin. There are three different types of TENS units, all used to treat pain. Doctors do not fully understand the way that TENS reduces pain, but they believe it involves several different pain pathways. The use of a TENS unit is generally safe, but they should not be used in people with cardiac pacemakers or with a history of seizures.

The battery-powered device delivers electrical current through small electrodes applied to the skin. It may be attached for minutes to hours at a time for pain relief. TENS may be used in people with chronic (lasting more than 3 months) low back pain.  

A 2019 review of the use of TENS in adults with chronic pain was unable to determine whether or not TENS was effective. This may be due to the quality of the studies involved.

Lumbosacral Brace

One type of lumbosacral brace is a flexible elastic lumbar belt, also called an elastic back support belt. This type of brace is worn around the lower back (lumbar area). The lumbar belts are often used to prevent back injuries in work settings.

One trial looked at the use of an elastic belt for the treatment of subacute back pain (lasting from 4 to 12 weeks). It showed a reduced need for pain medicine and improved functioning in those using elastic belts, compared to those without elastic belts.

Posture Correctors

Posture Correctors are also called posture devices, posture braces, back posture devices. A posture corrector helps to keep the back in a better position and helps to prevent and lessen back pain. 

Poor posture means that the back is not in a healthy, neutral position. This puts stress on the muscles and other structures of the back. This, in turn, may lead to back pain. 

A review of over 20 articles on back pain and ability to control posture when quietly standing found changes in the ability to control posture in those with back pain.

One study involved the use of a specific device to help correct posture. It looked at office workers before and after the use of the device and found improved neck, shoulder, and upper and lower back symptoms and less feelings of tiredness.

Shoe Insoles

Shoe insoles, also called shoe inserts, are products put into shoes to provide cushioning and support. They are usually made of gel, but may be made from other materials, depending on their purpose. 

Individual reports support the use of shoe insoles for the prevention and relief of low back pain. However, medical studies have not yet concluded that insoles help with low back pain

Herbal & Botanical Remedies and Dietary Supplements for Back Pain Relief

Some herbal & botanical remedies and supplements may be taken orally (by mouth). They may be in pill, tablet, capsule, drop, or other forms. 

Oral CBD is available in many different forms, including drops. 

Research on the safety and effectiveness of oral CBD is ongoing. It may be used to lessen pain. It may also be used for other symptoms and conditions. Some of the research includes:

  • The National Academies of Sciences (NAS) found significant evidence that cannabis was an effective treatment for long-term (chronic) pain. However, much of the research was done outside of the U.S. And, the types of cannabis used in the research were not the same as those commonly used in the U.S.

  • Reviews and meta-analyses of cannabinoids found the following:

    • Studies looked at the use of cannabinoids (tetrahydrocannabinol or THC alone and CBD combined with THC) in people with chronic pain. In general, there were improvements in pain measures, but they were not statistically significant.

    • Studies found evidence, although not high-quality, that cannabis-based medicines reduced long-term nerve (chronic neuropathic pain). All but two studies used a plant-based THC/CBD mouth spray (the other two used synthetic oral THC).

    • Observational studies and randomized controlled trials (RCTs) of the effectiveness of cannabinoids in chronic noncancer pain (CNCP) found a 30% reduction in pain in 1 out of 3 of those using cannabinoids. This was considered significant.

Coenzyme Q10 (CoQ10)

Coenzyme Q10 (CoQ10) is a nutrient found in the body, in particular in the heart, liver, kidneys, and pancreas. It may be used to treat people with pain, like those with fibromyalgia. Those with problems with their blood pressure should know that CoQ10 may lower blood pressure levels.

A person with fibromyalgia may have upper back pain or tenderness, as well as pain or tenderness in other areas of the body. It is a long-term (chronic) condition for which the exact cause is unknown. Other symptoms are tiredness, trouble sleeping and thinking, and anxiety.

Coenzyme Q10 supplements have been studied in people with fibromyalgia. These individuals may have low levels of CoQ10 and decreased response by cells to the enzyme AMPK. Both of these factors are related to the symptoms of fibromyalgia. Taking CoQ10 supplements can lessen the pain, tiredness, and poor sleep that occur with fibromyalgia

Two forms of coenzyme Q10 are available in supplements, ubiquinone and ubiquinol. Softgels with ubiquinol are more easily absorbed.

Devil’s Claw

Devil’s Claw or Devil’s Claw Root is from the roots of a plant native to some parts of Africa. This herbal product may help to decrease swelling or inflammation and pain. It may be taken alone or it may be part of some supplements with several ingredients. Devil’s Claw may further lower blood sugar levels for those taking medicines for diabetes. And, it may affect blood pressure and heart rate for those with blood pressure or heart problems.

Some research shows that taking a daily dose of extract of Devil’s Claw can lessen low back pain similarly to a nonsteroidal anti-inflammatory drug (NSAID).

Magnesium

Magnesium (Magnesium Malate, Magnesium Citrate) is a mineral found mostly in the bones. It plays an important role in many body functions. Magnesium may cause side effects for people with blood pressure, heart, kidney, or bleeding problems.

Magnesium supplements have been studied in people with long-term (chronic) pain conditions like low back pain and fibromyalgia. In one study, people with chronic low back pain that was difficult to treat, were given intravenous (IV), then oral (by mouth) magnesium. Results showed significant improvement in reducing pain.

SAMe

S-Adenosyl-L-methionine (SAMe) is a substance found throughout the body. A form of it is also available as a dietary supplement. SAMe works best when taken on an empty stomach. 

It should not be used in people with bipolar disorder and should be used with caution in people with Parkinson’s disease and with those taking antidepressant medicines.

It plays a role in many of the body’s functions. As far as pain, the body uses SAMe to make certain chemicals that play a role in pain sensation.

SAMe was included in an evaluation of complementary pain management approaches in the U.S. It was compared to nonsteroidal anti-inflammatory drugs (NSAIDs) used to treat osteoarthritis. It was found to be as effective as NSAIDs in reducing pain and improving ability to function. And, SAMe had fewer side effects. One point, however, there were a small number of people studied.

Turmeric

Turmeric, also known as curcuma, is actually a spice from the turmeric plant. It gives some Indian and Southeast Asian food its yellow color. It may be familiar to some as saffron

Turmeric contains curcumin and other chemicals that lessen swelling or inflammation. As a nutritional supplement, it may be available in softgels or capsules. It may also be part of some supplements that have several different ingredients.It is most effective when taken with fat-containing food or oil. 

Turmeric should be used with caution in people with diabetes, gallbladder disease, bleeding problems, gastroesophageal reflux (GERD), female hormone conditions, or low iron levels. Nor should it be used in women trying to get pregnant.

A recent review and analysis of dietary supplements found curcumin to significantly reduce pain in people with osteoarthritis of the hands, hips, or knees.

Willow Bark

Willow bark comes from the bark of several different types of willow trees. It contains salicin which is similar to aspirin. Like aspirin, it may reduce pain, swelling or inflammation, and fever. It should be used very carefully in people with blood pressure or bleeding problems, kidney disease, as well as some gastrointestinal (GI) problems.

This supplement may be available in capsule or liquid extract form.  It may also be part of some supplements that have several different ingredients.  

One type of willow bark was included in a review of herbal remedies for lower back pain. It seemed to reduce pain, however, the study quality was lacking. Another study comparing willow bark to a nonsteroidal anti-inflammatory drug (NSAID) found similar pain reduction.

OTC Topical Products for Back Pain Relief

A topical product is applied to the skin. For example, a person may apply a back pain relief cream. There are also other topical products, like gels, balms, and patches that can help lessen back pain. 

Lidocaine

Lidocaine is a local anesthetic.  This means that it provides pain relief to the area where it’s applied. Lidocaine actually blocks pain signals from the nerves.

When lidocaine is applied to the back, it temporarily numbs the area.  It is an ingredient in some products, like patches, creams, or sprays. One brand name is Aspercreme. Products with lidocaine should not be applied to the skin with a cut, scrape, or other open area.

Even though it may not always be recognized, studies have found that nerve pain (neuropathic pain) may be a large part of the pain in long-term (chronic) low back pain. Thus, lidocaine, by blocking the pain signals from nerves, may help to lessen the pain.

Salicylates

Salicylates [pronounced suh·li·suh·leits] may provide pain relief when applied to the skin. People are familiar with aspirin, another type of salicylate. Different salicylates are ingredients in over-the-counter (OTC) topical pain relievers. 

Aspercreme and IcyHot are two brands of OTC topical pain relievers containing salicylates. Products containing salicylates should not be applied to the skin with a cut, scrape, or other open area.

It is believed that salicylates work by increasing blood flow to an area. The increased blood flow provides warmth and soothes the area. The effect of topical salicylates for both short- and long-term pain (acute and chronic) is uncertain, based on the available studies.

Menthol

Menthol is a substance found in mint plants. It may provide pain relief when used in topical products. Menthol opens blood vessels where applied. This increases blood flow and helps with healing. Menthol also provides a cooling effect which may soothe muscles, nerves, and joints. An area treated with menthol should be protected from heat, like heat wraps or even sunlight.

There are patches, gels, and sprays with menthol as an ingredient. IcyHot is one brand with menthol. 

Menthol-containing topical products may lessen pain, in particular when other ingredients, for example, salicylates, are also contained in the product.

Topical Herbal & Botanical Products for Back Pain Relief

Some herbal & botanical products have ingredients that help with back pain when applied to the skin.

Topical Cannabidiol

Cannabidiol [pronounced can-na-bi-dye-ol] or CBD is one of two main substances from the cannabis sativa plant. The cannabis sativa plant has been used for thousands of years for its healing effects. CBD does not have a mind-altering effect.

Topical CBD may be applied to an area to lessen pain. It is available in different forms, including creams. The creams may also have other ingredients to improve healing and lessen pain.

Research on the safety and effectiveness of topical CBD is ongoing. Some of the research includes the following:

  • An animal study found transdermal CBD lessened the pain and inflammation of arthritis.

  • Topical cannabidiol oil was studied in people with nerve pain in their legs. After 4 weeks the people had less pain and other uncomfortable sensations.

  • Transdermal (absorbed through the skin) cannabidiol was studied in people with temporomandibular (joint of the jaw) disorders (TMD) that caused myofascial (coverings of muscle) pain. Those studied had less muscle activity and pain after applying the CBD for 2 weeks.

Capsaicin

Capsaicin [pronounced kap·sei·sn] is an herb also known as red pepper or chili pepper. Researchers believe topical capsaicin provides pain relief by temporarily changing the way the body feels pain. 

Products with capsaicin may cause burning when applied. Areas treated with capsaicin should be protected from heat, like heat wraps, or hot baths.

Capsaicin is the active ingredient in some topical products, like patches or creams. It may also be one of several ingredients in some herbal products. WellPatch, Capzasin HP, and Tiger Balm are three herbal & botanical products with capsaicin. 

Capsaicin-containing products have been used to treat many different painful conditions, especially those involving nerve pain. Studies have shown that capsaicin may be effective in reducing back pain

Comfrey

Comfrey is a medicinal plant that’s been used for thousands of years.Comfrey may be an ingredient in herbal & botanical topical products like cream, drops, and liniment (cream or liquid rubbed on the body to lessen pain).  Areas treated with comfrey should be protected from heat, like heat wraps, or hot baths.

Traumaplant Comfrey Cream, is one herbal & botanical product. Another type of product with comfrey is Herb Pharm drops. And, comfrey may be an ingredient in products like Four Elements botanical liniment.

Comfrey was found to be effective for upper and lower back pain in a study comparing it to placebo. Studies also found that topical comfrey may lessen the pain and swelling of muscles and joints in many conditions. They include osteoarthritis, back muscle pain, and pain following sports injuries or accidents

The next two products are called counterirritants. This means that they irritate nerve endings in such a way that it lessens pain.

Camphor

Camphor is from the wood of the camphor laurel tree. It is a herbal & botanical product found in balms, gels, and creams. Camphor is approved by the Food and Drug Administration (FDA) to relieve pain when applied to the skin. It should not be used by people with liver problems.

Products with camphor include Rhulief Pain Relieving Balm, Salonpas Deep Pain Relieving Gel, and Bengay Ultra Strength Topical Analgesic Cream.

Topical camphor may relieve pain, irritation, and itching. Studies have shown that applying camphor to the skin helps relieve pain and inflammation

Menthol

Menthol is the substance in mint plants. It may provide pain relief when used in topical products. Menthol opens blood vessels where applied. This increases blood flow and helps with healing. Menthol also provides a cooling effect which may soothe muscles, nerves, and joints. The area treated with menthol should be protected from heat, like heat wraps or even sunlight.

There are patches, gels, and sprays with menthol as an ingredient. Dr. Blue Cool Gel is one herbal & botanical product with menthol. 

Menthol-containing topical products may lessen pain, in particular when other ingredients, for example, salicylates, are also contained in the product.

Educational Videos for Back Pain Relief

The right exercise information, delivered in an easy-to-understand way, can be used to help lessen back pain. Individualized information helps to ensure that exercise is based on the person’s medical history and back pain symptoms.

Exercise is an extremely important part of back pain care. Guidelines for the treatment of low back pain and neck pain include exercise in their recommendations.

It may be difficult to know what’s safe to do. And, it may be challenging and expensive to go to a physical therapist for guidance. GoodPath offers different exercise videos based on current level of exercise and particular diagnoses related to back pain. They include:

  • A Simple Stretching and Strengthening Exercises video to improve flexibility and prevent further injury. The exercises are most helpful for those with long-term (chronic) back pain with no specific injury. And, for those who are less active or new to exercise.

  • An Advanced Stretching and Strengthening Exercises video to improve flexibility and prevent further injury. The exercises are most helpful for those with mild to moderate back pain. And, for those who are also active and have experience with exercise. 

  • A Stretching and Strengthening Exercises (Muscle Strain) video to improve flexibility and prevent further injury. The exercises are most helpful for individuals who have a recent injury of the back muscles.

  • A Stretching and Strengthening Exercises (Herniated Disc) video for strengthening the back and stabilizing the spine. The exercises are for those with a diagnosis of herniated disc.

Related article:

5 Mistakes to Avoid for At-Home Treatment of Back Pain

How Goodpath Can Help

A person with back pain -- whether it’s new, has been there a while, or has recurred -- is likely in need of relief. There are many products and treatments available. And even more possible combinations of those products and treatments. 

So that a person can get the best care possible, it’s important to consider their medical history and back pain symptoms. That way the treatment plan can be individualized. And, by considering the appropriate products and treatments, it can also be complete. 

Our back pain quiz was designed to guide you to the best set of solutions for your exact situation.  can provide you with a plan to meet your specific needs.