I have been taking lortab for pain for along time now. It used to work really well now not so much can I get something different for back pain?

Refer to answer. Always there is a cause for acute and chronic pain. Just taking pain medication is not the answer to the problem. You need to have a complete work up to find the causes. Have your doctor to do the following tests CBC diif esr. Ana, ra, crp=quantitative, uric acid, hba1c, tsh, lipids. From the above and complete history and physical we can always can find the reason and treat.
Tolerance vs problem. There are two main reasons that medications stop working. Either the underlying problem is getting clinically worse or you are getting used to the meds, which is called "tolerance". Either way, it is best not to just cover up the issue with analgesics. Much better to try to actually treat the problem and the cause of the pain. Get the full workup so you have some better options.