Tramadol or Diazepam for Back Pain: What's Best For You? -
May 11, 2023

Tramadol or Diazepam for Back Pain: What's Best For You?

Tramadol or Diazepam for Back Pain: What's Best For You?

By Dr Shoaib Muhammad , published on May 11, 2023
Dr Dusan Sekulic MD

So, your back pain is bad, and you're considering medication. You're not the first person, and you won't be the last. 

Here in the UK, back pain affects some 2.5 million people every day and treating it costs the National Health Service (NHS) over one billion pounds annually.

That's a lot of sore backs.

Healthcare providers often prescribe medications like tramadol and diazepam to manage pain.

But which one should you take?

Between diazepam and tramadol, tramadol is much more often prescribed for back pain. Diazepam isn't usually recommended as a first-line treatment because it doesn't address the root cause of back pain.

That's the short answer. 

If you'd like to know more, read on for more in-depth info about tramadol, diazepam, and their roles in managing back pain.

We'll also explore other painkillers and some natural alternatives for the job.

What Is Tramadol?

Yes, tramadol can help with your back pain. It's a prescription pain relief medication that belongs to a class of drugs known as opioids [1] and is typically used to treat moderate to severe pain. That often includes pain caused by surgery or injury [2].

Tramadol works by changing how the brain perceives pain, rather than blocking the pain signals [3]. It's available in both immediate-release and extended-release formulations.

What Is Tramadol Used For?

Tramadol is used to treat various pain conditions, including dental pain, post-surgical pain, and chronic pain [2]. It can also treat pain associated with conditions like fibromyalgia and neuropathy [1].

It's also used as a complementary treatment for other pain management methods, like physical therapy and acupuncture [3].

Is Tramadol Good for Your Back Pain?

Tramadol can be effective in treating your back pain, particularly when your pain is moderate to severe. It's often used when non-opioid medications, like acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs), aren’t doing the job [3].

That said, it's important to note that Tramadol isn’t specifically approved for the treatment of back pain by the NHS. Instead, it's approved for the treatment of pain in general and some doctors will prescribe it for your back problem [2].

How Does Tramadol Help Your Back Pain?

Tramadol works by changing how the brain perceives pain by binding to the mu-opioid receptors in the brain. Those receptors are responsible for transmitting pain signals [1].

This can help reduce the sensation of pain, making it more manageable. Tramadol also works well with other pain management techniques like physical therapy.

In some cases, this drug may be used in combination with muscle relaxants to help ease up the muscle spasms that can contribute to back pain [4].

Also worth noting is that Tramadol should be used under the guidance of a healthcare professional and only as directed.

That's common for many drugs, but especially with tramadol because it has the potential to be habit-forming and can cause side effects [1]. It's not a substance to be taken lightly.

Why Might Tramadol Be Unsuitable for Your Back Pain?

While tramadol can be effective at treating back pain, it's not suitable for everyone. If you’ve got a history of substance abuse or addiction, you might want to avoid it [2].

There are a few potential side effects too, like dizziness, nausea, and constipation [1]. Because tramadol interacts with other medications, always share details of anything else you're taking with your healthcare provider [3].

What Is Diazepam?

Diazepam is a prescription medication that belongs to the benzodiazepine class of drugs. You may have heard of its more common brand name, Valium. It works by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter in your brain that slows down the activity of the central nervous system [1]

Diazepam is commonly used to treat:

  • Anxiety
  • Muscle spasms
  • Seizures

The drug is available in tablets, oral solutions, and rectal gel.

Diazepam has a calming effect on the brain and is often prescribed to help patients relax before surgery or other medical procedures [1].

What Is Diazepam Used For?

Diazepam is commonly used to treat anxiety disorders, including generalised anxiety disorder, panic disorder, and social anxiety disorder [6].

The medication can also be used to manage alcohol withdrawal symptoms, muscle spasms, and seizures. Diazepam is also prescribed for patients with insomnia because it can help them fall asleep and stay asleep throughout the night [6].

Is Diazepam Good For Your Back Pain?

Diazepam isn’t typically recommended as a first-line treatment for back pain. It isn’t effective in addressing the underlying causes of your pain, like a herniated disc or spinal stenosis [4]. However, it may be used in combination with other medications to alleviate the muscle spasms that often accompany back pain [3].

How Does Diazepam Help Alleviate Your Back Pain?

Diazepam is a muscle relaxant that works by reducing muscle tension and spasms [7]. Muscle spasms are a common cause of back pain, and diazepam can help to ease the tension in the muscles and alleviate the pain.

It's often used in combination with other medications or therapies, like physical therapy, to manage back pain symptoms.

Why Isn't Diazepam Suitable For Your Back Pain?

Diazepam isn’t typically recommended as a first-line treatment for back pain because:

  • It doesn’t treat the underlying cause
  • The medication can be habit-forming. That means it may cause dependence and withdrawal symptoms once it's treated your problem and you don't need it anymore [5].
  • Long-term use of diazepam can also lead to tolerance, which means that you may need higher doses to achieve the same level of pain relief. Of course, that only makes withdrawal worse.

For these good reasons, diazepam is typically kept for short-term use and isn’t considered a long-term solution for back pain management [8].

tramadol or diazepan for back pain infographic

Other Painkillers For Back Pain

Dealing with back pain can be challenging, and finding effective pain relief is rarely easy. Apart from these two pills, there are other painkillers available in the UK market that can also help ease your symptoms.

Let's explore some other painkillers.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a common painkiller option. They work by reducing inflammation in the body, which can help alleviate pain. NSAIDs are available over-the-counter or by prescription.

They include drugs you probably already know like ibuprofen, naproxen, and aspirin [6].

Worth remembering is that long-term use of NSAIDs can increase the risk of stomach ulcers and kidney damage.

For that reason, it's really best to use them sparingly and under the guidance of a healthcare professional rather than reach for them too often as a quick fix.

Acetaminophen (Paracetamol)

Acetaminophen, also known as paracetamol, is another painkiller option for back pain. It works by blocking the production of prostaglandins, which are responsible for causing pain and inflammation in the body [6].

Acetaminophen is available over the counter and is generally considered safe when used as directed. If you take too much acetaminophen, it can lead to liver damage, so always follow the recommended dosage.

Muscle Relaxants

Muscle relaxants are another option for back pain relief. They work by reducing muscle spasms, which can cause pain and discomfort [4].

Some of the commonly prescribed muscle relaxants include cyclobenzaprine, tizanidine, and methocarbamol [5]. But, muscle relaxants can cause drowsiness and dizziness, so avoid using heavy machinery or driving while taking them.


Opioids are a strong painkiller option generally reserved for severe pain that isn’t relieved by other painkillers. They work by binding to receptors in the brain and spinal cord, which can help reduce pain [2].

Some commonly prescribed opioids include oxycodone, hydrocodone, and codeine. But, opioids can be highly addictive and cause side effects like constipation, dizziness, and drowsiness.

Always use these substances with caution and under the guidance of a healthcare professional.


Steroids are another option for back pain relief, particularly in cases where there's inflammation in the body. Steroids work by reducing inflammation and swelling, which can help alleviate pain and discomfort [3].

Some commonly prescribed steroids for back pain include prednisone, methylprednisolone, and dexamethasone. The downside is that steroids can cause side effects like weight gain, mood changes, and an increased risk of infection.

Steroids should always be tapered off with the consultation of a qualified healthcare professional or a doctor.

Back Pain Relief Without Pharmaceuticals

When it comes to managing back pain, people often reach for the pills. While these drugs can be effective in managing pain, they aren’t always necessary.

In some cases, painkillers may mask the pain, making it difficult to identify the underlying cause of the pain. This can also lead to delayed treatment, which can ultimately worsen your condition.

Here are some natural alternatives. They'll be easier on your body and help avoid nasty side effects like dizziness, drowsiness and nausea. Not to mention the possibility for addiction.

Natural Options For Managing Back Pain

Fortunately, you can lean on several natural options for managing your back pain. Here's a list:

  • Stretching: Stretching can help you relieve muscle tension and improve flexibility. If you’ve got back pain, you can try gentle stretches like hamstring stretches or hip flexor stretches. Just remember to go easy on yourself. Start slowly and gradually increase the intensity of the stretches, otherwise you could make your pain worse.
  • Chiropractic: Chiropractic care involves the use of spinal manipulation to improve spinal alignment and relieve pain. It's effective at managing back pain, particularly when combined with exercise and other therapies. [2]
  • Deep Heat: Okay, it's not technically natural but there are natural alternatives to Deep Heat such as Tiger Balm which is also great for back pain.
  • Physical therapy: Physical therapy involves exercises and stretches designed to improve strength, flexibility, and range of motion. It can also involve techniques like massage and hot/cold therapy. Physical therapy is effective in managing back pain, particularly when combined with other therapies. [1]
  • Yoga: Yoga combines stretching, breathing, and meditation to improve physical and mental well-being. It's effective in managing back pain, particularly when combined with other therapies. [2]
  • Acupuncture: Acupuncture involves the use of thin needles to stimulate specific points in the body. It's effective at managing back pain and, like yoga, is another treatment that's effective when combined with other types of therapy. [2]

When Pharmaceuticals May Be Necessary

While natural options can help your symptoms, there are situations where pharmaceuticals may be necessary.

For example, if your pain is severe and debilitating, or if it's caused by an underlying medical condition like a herniated disc or spinal stenosis. 

I'd like to reiterate once more that it's super important to use these drugs under the guidance of a healthcare professional and to follow the prescribed dosage.

Watch out for red flags if you've got back pain. If you get any of the symptoms in this article, speak with a doctor before thinking about which painkillers to take.

The Bottom Line: An Expert's Advice

Worth noting is that the use of tramadol and diazepam for back pain is a highly debated topic among experts in the field. While these drugs can provide relief for some patients, they also come with potential side effects and risks.

Always carefully weigh the potential benefits and risks of these drugs before taking them for your back pain.

In many cases, non-pharmaceutical options such as physical therapy, chiropractic care, and stretching exercises may be just as effective, if not more so, in reducing back pain. Even proper desk posture can help.

That means that you could get all the healing benefit without any of the potential risks and side-effects that comes with medication.

Always communicate openly with your healthcare provider about their pain and treatment options to ensure you receive the most appropriate care for your situation.

Ultimately, the decision to use tramadol or diazepam for back pain should be made on a case-by-case basis with careful consideration of the potential risks and benefits.


1. Medline Plus. Medicines for back pain.

2. Annals Of Internal Medicine. Medications for Acute and Chronic Low Back Pain.

3. NYU Langone Health. Medication for Back Pain.

4. Health Central. Muscle Relaxants for Back Pain and Neck Pain.

5. Spine Health. Muscle Relaxants: List of Common Muscle Relaxers.

6. WebMD. Which Medicines Help With Low Back Pain?

7. The best meds for back pain. Harvard Health Publishing.

8. North American Spine Society. Diagnosis and treatment of low back pain.