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Medical Author:

Catherine Burt Driver, MD

Catherine Burt Driver, MD

Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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No medication has been proven to reverse the degenerative process of spondylosis. Treatment of pain from spondylosis commonly includes anti-inflammatory medications, analgesics (pain medications), and muscle relaxants. Nonsteroidal anti-inflammatory medications, or NSAIDs, can be very effective in relieving back and neck pain from spondylosis. Some of these medications, such as ibuprofen (Advil, Motrin) and naproxen (Aleve), are available without a prescription. Other NSAIDs are prescription strength and may be prescribed by your health-care professional. Muscle relaxants such as cyclobenzaprine (Flexeril) and tizanidine (Zanaflex) are examples of prescription medications that can relieve the muscle spasm associated with spondylosis. Analgesics (pain medications), such as acetaminophen (Tylenol) and tramadol (Ultram), are used to treat pain. If the pain is extremely severe, sometimes a narcotic medication (Norco, Vicodin or others) is prescribed for the first several days.

Certain antidepressants are helpful in treating chronic back pain. Medications termed tricyclic antidepressants, including amitriptyline (Elavil) and doxepin (Sinequan), have been used for many years, in low doses, to treat chronic back pain, neck pain, and other pain. Recently, another antidepressant, duloxetine (Cymbalta), has been shown to improve chronic back pain. Cymbalta is approved by the Food and Drug Administration (FDA approved) to treat chronic low back pain as well as other chronic pain conditions.

Some people find topical medications, which are massaged directly onto the location of the pain, helpful in relieving pain from spondylosis. These medications work in different ways, and many are available without a prescription. Some examples of topical medications include Aspercreme, which contains aspirin, and is anti-inflammatory. Capsaicin cream is another topical medication which many find helpful. Capsaicin is the active ingredient in chili pepper and should not be used on areas where the skin is cut or irritated. After application, thorough hand washing is important, especially prior to touching the face, to avoid irritation from the capsaicin.

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