Spinal arthritis is inflammation of the joints that make up the spine. Typically, the most effective medications include analgesics, NSAIDs, acetaminophen, steroids, muscle relaxants, and DMARDs.

Arthritis is a group of conditions that affect the joints. In spinal arthritis, the facet and sacroiliac joints become inflamed, causing pain.

This can occur as a result of natural wear and tear of the spine or inflammatory conditions such as spondyloarthritis and rheumatoid arthritis.

Many medications are available to help reduce pain and inflammation in the spine.

In this article, we discuss the types of medication available to treat spinal arthritis.

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Spinal arthritis, or arthritis in the back or neck, is inflammation in the spine’s joints.

The spine contains many joints that enable movement, which can become inflamed. This can result from natural wear and tear of the spine or from inflammatory conditions.

Spinal arthritis may affect the facet joints and the sacroiliac joint. Facet joints are present between vertebrae in the spine and provide stability to the spinal column while allowing movement. The sacroiliac joint connects the bottom of the spine (the sacrum) to the top of the pelvis (the ilium).

Although many types of arthritis can affect the spine, the most common types are:

  • Osteoarthritis: Also known as degenerative arthritis, this is the most common type of spinal arthritis. This type occurs when the joint cartilage begins to break down, leading to pain and inflammation.
  • Rheumatoid arthritis: This is an autoimmune condition, which means it occurs as a result of the immune system mistakenly attacking the lining of the joints. Because this type does not result from wear and tear, health experts refer to it as inflammatory arthritis.
  • Spondyloarthritis: This is a group of inflammatory conditions that affect the spine. Spondyloarthritis has several types, including ankylosing spondylitis, psoriatic arthritis, and reactive arthritis.

Learn more about the different types of arthritis.

Many types of medications are available to help relieve pain due to spinal arthritis.

The Arthritis Foundation recommends the following medications.


Analgesics are a group of drugs that help relieve pain. Typically, these drugs reduce inflammation or change how the brain processes and perceives pain. There are three main types of analgesics:

  • Simple, non-opioid analgesics: This category includes acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
  • Compound analgesics: These are made from a combination of two drugs that work together to relieve pain. Acetaminophen, aspirin, codeine, and dihydrocodeine are the most common components of analgesics.
  • Opioid analgesics: This category includes oxycodone (OxyContin), hydrocodone (Vicodin), and codeine.

To reduce the risk of side effects, doctors usually advise a person to try simple, non-opioid analgesics before using stronger medications such as compound or opioid analgesics.

Opioids can reduce pain by binding to opioid receptors, blocking the body’s pain messages. However, use of opioids can lead to misuse disorders, overdose incidents, and death.

Some types of analgesics are available over the counter. However, stronger types are only available with a prescription.


NSAIDs are simple, non-opioid analgesic drugs that reduce inflammation to help relieve pain.

NSAIDs help by preventing an enzyme called cyclooxygenase from producing hormone-like chemicals called prostaglandins. These chemicals are one of the biggest contributors to inflammation.

Common NSAIDs include:

Many are available over the counter, but a doctor can prescribe stronger doses. These medications often work within a few hours to help reduce pain and inflammation.

When taking NSAIDS, people should follow the instructions of their doctor or the medication label. Not doing so increases the risk of adverse events, such as stomach, kidney, or heart problems; fluid retention; rashes; or other allergic reactions.

Learn more about the risks of taking too much ibuprofen.

Acetaminophen (Tylenol)

Acetaminophen (Tylenol) is another type of simple, non-opioid analgesic drug. It also helps reduce pain but, unlike NSAIDs, does not reduce inflammation.

It is a common active ingredient in pain relief medications and does not carry as many risks as NSAIDs. However, there is still a risk of liver damage from using acetaminophen, so people should follow the dosage recommendations of their doctor or the medication label.

A person should limit or avoid alcohol consumption when taking acetaminophen, as alcohol can increase the toxic effects the drug can have on the liver.

Learn more about the risks of taking acetaminophen with alcohol.

Topical rubs, creams, and sprays

Topical pain relievers are medications that people apply to the skin over inflamed joints. While they are typically better at relieving pain in soft tissues, they may provide some relief from minor discomfort due to spinal arthritis.

If a person is taking other medications, such as NSAIDs, it is advisable to consult a doctor before using topical treatments.

Topical products are available in different formulations, such as sprays, creams, gels, and patches, and can contain various ingredients. Examples include:

  • salicylates
  • topical NSAIDs, such as diclofenac gel (brand names include Voltaren and Pennsaid)
  • lidocaine
  • menthol
  • capsaicin
  • CBD

Learn more about the best creams for arthritis.

Steroid injections

Steroid injections, also known as corticosteroid injections, involve a healthcare professional injecting an anti-inflammatory medication directly into the joint to relieve pain. These medications are synthetic versions of natural hormones and differ from anabolic steroids.

For spinal arthritis, healthcare professionals can inject steroids into the facet joint or sacroiliac joint. These options can provide pain relief for several weeks or months. Potential risks may include infection, bleeding, nerve injury, post-procedure pain, and allergic reaction.

Muscle relaxants

Muscle relaxants are a group of drugs that help relax muscles and may be beneficial for reducing muscle spasms and decreasing muscle pain.

A doctor may prescribe them alongside NSAIDs. Muscle relaxants can cause drowsiness, so they may help an individual sleep if back pain keeps them awake.

Disease-modifying antirheumatic drugs (DMARDs)

DMARDs, also known as biologic response modifiers (BRMs), are a category of biologics and biosimilars that may help treat inflammatory forms of arthritis.

By using living cells and organisms, these specialized medications can block a step in the inflammation process — without suppressing the entire immune system — to help relieve symptoms of arthritis.

Learn more about the best medication for joint pain.

If medications are unsuccessful, then a person may consider surgery. Surgical options can help stabilize the spine and reduce movement in painful joints.

For example, a spinal fusion involves welding two or more vertebrae together to prevent pain from movement. However, it can make the spine less flexible and reduce a person’s range of motion.

To confirm a diagnosis of spinal arthritis, a doctor will likely use a combination of the following diagnostic methods:

  • medical history and physical exam
  • imaging scans
  • blood tests
  • joint aspiration (a procedure to remove fluid from the space around a joint)

To help locate the painful joint, a doctor may numb it with an injection and check whether the person stops experiencing pain.

If a person experiences chronic pain, swelling, or stiffness in their back and the discomfort prevents them from performing daily activities, it is advisable for them to consult a health expert for a medical evaluation.

In general, healthcare professionals recommend making a medical appointment if joint symptoms last longer than 3 days or if a person has several episodes of joint symptoms in a month.

Spinal arthritis is inflammation in the joints of the spine. This can occur as a result of wear and tear or inflammatory conditions.

A doctor can recommend a variety of medications to help relieve pain and discomfort from arthritis. Typically, these drugs work by reducing inflammation.

Additionally, people may consider natural options, such as exercise, alongside medical therapy.