Kraus Back & Neck Institute Spine PainPain Treatment - Kraus Back & Neck Institute Kraus Back & Neck Institute : 281.446.3876 (281.44.NEURO)
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At the Kraus Back and Neck Institute (KBNI), we specialize in non-surgical as well as surgical treatments of Back and Neck Pain.
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Pain Management


Tricyclic Antidepressants
Antidepressants For Lower Back Pain Management

Antidepressants are the most commonly prescribed medication for depression, but can be an effective treatment for chronic pain, even if depression isn’t a factor. Antidepressants work best for pain caused by arthritis, low back pain, pelvic pain, fibromyalgia, tension headaches, migraines and nerve damage from diabetes or shingles.

Low doses of tricyclic or tetracyclic antidepressants increase neurotransmitters in the spinal cord that may reduce pain signals, but they don't work immediately. Relief from an antidepressant may not occur for a week or so and maximum relief may take several weeks. Antidepressants may also help you sleep.

Talk to your doctor about the risks and benefits of treating your pain with antidepressants and find out if it is the right course of treatment for you. Follow directions on the label carefully and ask your doctor or pharmacist to explain any part you do not understand. Take only as directed.

REMINDER: You should always talk to your doctor before beginning a new medication regimen. These suggestions do not to substitute for medical advice. Please consult your physician.

Types of Antidepressants

Amitriptyline Hydrochloride

Brand Name(s) Elavil

Relieves: Major depression and chronic pain

Available Over-the-Counter: No

Mechanism of action: Amitriptyline hydrochlorideaffects levels of chemicals (serotonin, norepinephrine, acetylcholine) which are linked to mood, emotion and mental state.

Side Effects

  • Common: drowsiness, dizziness, lightheadedness, headache, dry mouth, sensitivity to light, weight gain, nausea
  • Less common: heartburn, insomnia, diarrhea, increased sweating, vomiting
  • Serious: confusion, heartbeat irregularities, hallucinations, seizures, fatigue or drowsiness, blurred vision, restlessness, trembling, shaking, weakness

Note: When stopping the medication, taper over five to seven days.


Nortriptyline Hydrochloride

Brand Name(s): Pamelor

Relieves: Major depression, anxiety disorders, panic disorders, chronic pain

Available Over-the-Counter: No

Mechanism of action: Nortriptyline hydrochloride affects levels of norepinephrine, a chemical in the brain which may be linked to mood, emotions and mental state.

Side Effects

  • Common: drowsiness, dizziness, headache, unpleasant taste, fatigue, weight gain, nausea, increased appetite
  • Less common: heartburn, difficulty sleeping, diarrhea, profuse sweating, vomiting

Note: Do not place in reach of suicidal patients. If you have considered suicide or are currently having suicidal thoughts, consult with your doctor on alternative pain regimens.

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Gary Kraus, MD - Back & Neck Institute
Masaki Oishi, MD
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MISS techniques reduce the need for large incisions, muscle cutting, and a long period of recovery.
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