People with severe, chronic back pain, especially those who have gone through the trials of surgery, sometimes find that NSAIDs and muscle relaxants are not sufficient to cope with the pain. For this group, narcotic medications or opioids like Co-Codamol can be the answer. Studies indicate that as many as 70% of back pain patients have used opioids in their pain management program.

Opioids act on pain receptors in the brain and nerve cells to alleviate pain. Milder, shorter-acting versions, like Co-Codamol which is formulated from paracetemol with codeine can often provide benefits for this group without the need to take recourse in stronger medications such as morphine.

Their most common side effects include:

Drowsiness and sedation
Constipation
Risk of dependency
Allergic reactions, such as hives and itching

So caution is warranted when using these medications. But for some people long term use under medical supervision is the only option as otherwise pain makes their lives intolerable, and if they come off the medication they just cannot function.