What is sciatica?

Sciatica is a term that describes pain radiating along the path of the sciatic nerve. The sciatic nerve branches from the lower back through the hips and buttocks down each leg. Sciatic pain usually occurs as a sharp or burning pain on just one side of the body radiating from the lower back down through the back of the leg. Most commonly this happens when part of the nerve is compressed. The nerve might be compressed by something like a herniated disk, bone spur on the spine, or narrowing of the spine (called spinal stenosis).

Usually, a good place to start with treatment for sciatic nerve pain is with over-the-counter medications like ibuprofen (Advil, Motrin), naproxen (Aleve), or acetaminophen (Tylenol) in addition to physical therapy. If you feel the need to take the over-the-counter medications for a long period of time, talk to your doctor first. Physical therapy, stress reduction, mindfulness, and cognitive behavioral therapies are preferred over pharmaceutical options. However, if pain is not adequately controlled with the above options, there are some prescription medications that may be helpful when prescribed by a healthcare provider.

Prescription Treatments for sciatic nerve pain

Gabapentin (Neurontin)

• Gabapentin is a medication used to treat seizures and nerve pain
• Has been shown to help with sciatic nerve pain
• May cause side effects such as drowsiness, dizziness, fatigue
• Caution with alcohol or other medications that cause these types of side effects, as the sedating side effects may be enhanced and cause harm

Pregabalin (Lyrica)

• Pregabalin is a medication used to treat seizures and nerve pain
• Research studies do not necessarily show a benefit for sciatic nerve pain, but this medication is still used for treatment
• May cause side effects such as drowsiness, dizziness, fatigue
• Caution with alcohol or other medications that cause these types of side effects, as the sedating side effects may be enhanced and cause harm

Duloxetine (Cymbalta)

• Duloxetine is a medication used to treat depression, anxiety, and pain
• Has been shown to reduce sciatic nerve pain
• May cause side effects such as drowsiness, fatigue, headache, nausea, or vomiting

Amitriptyline (Elavil)

• Amitriptyline is a medication used to treat depression, pain, and migraines
• Effective for sciatic nerve pain, especially in combination with gabapentin
• May cause side effects such as drowsiness, confusion, fatigue, headache, low blood pressure, fast heartbeat
• Caution should be taken if you are over the age of 65, as the side effects may be more pronounced and/or more risky

Not all medication treatment options are right for everyone. The best thing to do is discuss the risks and benefits of all the different treatment options with your doctor and together decide what is best for you.

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References:

1) Sciatica – Symptoms and causes – Mayo Clinic

2) UpToDate®