Hi and thanks for posting your question on HCM. I am sorry that you have chronic low back pain. Hydrocodone: common side effects include nausea and constipation, long term side effects include tolerance, requiring higher doses to achieve control of pain and dependence Acetaminophen : safest drug among the three but may impact liver function if taken long term Diclofenac: gastric irritation, long term - kidney impairment I understand from the history provided that you have tried many procedures to try to get better - the other thing I am worrying about is your gender and age. Women lose calcium faster than men and after menopause, hormonal loss causes bone health to go downhill, complicating pain issues. Men also lose calcium and when on long term drugs, their hormones get suppressed and low as well, encouraging bones to become more brittle and thus, more painful. Either way, consider getting a bone densitometry test done to see where your bone health is at. Consider your posture. If you are always sitting, be sure to have sufficient firm support with a good cushion. Try to move around every half an hour when awake. How is your mattress? Does it provide you with good back support at night? How do you pick things up? Bending down is not recommended. Consider squatting down to retrieve fallen objects and tie shoe laces. Heavy lifting should be avoided right now. I humbly recommend that you consider other methods - work with a certified therapist to strengthen your lower back muscles. Gentle pilates and yoga may help. Exercise (supervised) can help you recover mobility and reduce pain. If you are overweight, you need to lose weight to ease your pain. Review your diet - reduce the sugar and carbohydrates in it (these cause inflammation and pain) and increase healthy fats and foods that fight inflammation such as cucurmin, bromelain and ginger. Cut out preserved and processed foods - these send inflammation levels sky-high. Supplement generously with high grade omega 3, use a bone complex that contains calcium, phosphorus, magnesium, Vits A,D,E and K. Do consider natural pain relievers such as MSM (methylsulfonylmethane), cucurmin and bromelain. Studies have shown that bio identical hormones can greatly improve pain - this applies to back problems as well. Different countries and health systems have different thoughts on bio identical hormones but evidence shows that it can help those afflicted with chronic disease cope far better. Personally, I work with both nutrition and bio identicals and have helped many feel better with testosterone, DHEA and dessicated thyroid - even women need testosterone. If you have access to a doctor that has a holistic approach, try meeting up with them and discussing your options. Other pain management techniques include acupuncture, transcutaneous electrical nerve stimulation (can now be done at home) and meditation. This is my sincere advice. If you were to come see me physically, I would set you up on nutrition support, bio identicals and therapy. I am a doctor who hates long term painkillers and actively remove them from my patients daily medication. Take care and good luck Dr Shabnam