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SCIATICA PAIN RELIEF
Copyright March 2016 by Laurence E. Badgley, M.D.
A question has been asked about the favored pain medication for sciatica. As with all medical treatments, what works best is what rationally follows upon the cause. Sciatica is not a disease or a specific disorder. Rather, it is a pattern of pain. There are several different disorders, mostly musculoskeletal, which arouse the sciatica pain pattern. One common cause of sciatica is spine nerve root impingement at the lumbar spine foramina level. Surgical release of stenotic constrictions causal of neural impingement can be curative. Another common cause of sciatica is sacroiliac joint hypermobility due to joint ligament injury and laxity. Osteopathic manipulation, sacroiliac joint belts, Prolotherapy, and fusion of the sacroiliac joint can all be efficacious.
Fortunately, most episodes of sciatica are self-limiting, likely because most episodes of sacroiliac joint subluxation are self-limiting; even though they can be recurrent.
Oxycodone is a wonderful analgesic medication with a wide safety margin, but the insurance industry, especially the Worker’s Compensation faction, lobbied the government and spun fictitious tales of epidemic overdose deaths to effectively abolish humane pharmacologic outpatient pain control in the United States.
Cannabis concentrates like hashish are effective analgesics when ingested or inhaled, and are absent qualities of dependency and addiction. The Cannabis flower can be soaked in alcohol or oils, like coconut or olive oil, to create topical salves that penetrate the skin and ameliorate inflammation in subcutaneous soft tissues, such as the sciatic nerve.
Massage and myofascial therapies probably work by altering anoxia and increasing blood flow within spastic soft tissues, which are part of the body’s compensatory response to neural impingement and neuropathic pain arousal like sciatica.
All pain is revealed via central nerve tissue functions within the brain. Brain function is malleable, and biofeedback and mindfullness therapies are learned methods to alter the brain’s perception of pain.
There is no one therapy or medication that is “the best” for sciatica. The sequence of therapies that works best arises from a collaboration of the patient and the medical practitioner. Indeed, the patient is the true pain meter within this collaboration, and often a trial and error method is what works best.
Laurence E. Badgley, M.D.
Before giving my opinion on how to best treat sciatic pain, I went ahead and Read all the answers provided up to now by the other responding authors . Now, the question is. What are the best pain killers for sciatic pain?.
In my opinion sciatica, how the condition is called is one of the most common and bothersome types of neuralgic pain. It’s important for me before I make a decision on the way I’m going to treat a sciatic pain episode ( providing PLEASE it’s not a chronic sciatica ) to take into consideration many factors, the patient’s age, medical history,imaging reports, frequency of the events and their severity, and even what the patient does for a living and his/her social life and even hobbies and sports they might practice.. All this information should be taken into consideration before making a decision on the best course of action for treatment of sciatica, and this is because sciatica is caused by many things. Lumbar Radiculopathy, lumbar spine stenosis post traumatic lumbar Radiculopathy or nerve damage, bulging degenerative changes of the lumbar spine, posture. And is being described that even in man that carried a bulking wallet in their back packets have more chance or suffering from a sciatic like neuralgia. Thanks God that in most cases sciatic pain comes and goes unless there is a serious irreversible pathology of the lumbar region of the spine which could be post traumatic, degenerative,, etc.
In my practice I have seen over time that otherwise proven by radiological imaging. The most frequently causes of sporadic sciatic nerve pain events are a result of the patient’s poor knowledge of proper posture in any given case. Ex: How to pick up objects, heavy or not, how to sit straight etc
Next for me as a neurologist is to rule out the possibility of muscle spasms, specifically para spinal muscle spasms that have become spasmodic with time producing lumbago because of compensating for other muscles in this kind of neuropathic pain that always irradiates to the right or left lower extremities depending on the direction in which the foramina is being pushed after taking all this factors into consideration. If the patient is an elderly person I will suggest a nerve block under fluoroscopy. Some NSAID meds for a week and will give the patient a booklet with exercises to be done there times a week and also the posture that will avoid another event. I don’t like to prescribe narcotic pain medications to anyone unless irremediably necessary. Because you never know how a patient is going to react to it, even in a short term basis, some of them become accommodated the pain killer and now you have two problems in your hands a recurring neuralgia and an addicted patient. And as I was saying in elderly patients it’s very dangerous to prescribe strong pain killers because imagine that the patient gets up in the middle of the night to use the bathroom with a pain and a narcotic pain killer he could fall and kill himself.
To end I will say that the best med for a sciatic pain for me are NSAID Very short term narcotic pain killers like oxycodone hydrocodone etc ( but I prefer to avoid them ) Physical therapy. William’s exercises. Methylprednisolone etc and of course blocking the nerve if needed. Good luck!
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Whatever works for you.
I know that sounds unhelpful, but pain’s one of those idividual things, and what works for me may not work for you- and vice-versa.
Sciatica is caused by an inflammation of or injury to the sciatic nerve; it is characterized by low back pain and radiculopathy- or pain which radiates- usually down one side, through the buttock into the thigh. It can be darned painful and make everyday movement very difficult.
What works for me, is heat and ibuprofen, oh, and proper positioning when I sleep- making sure I have a pillow between my knees. If, and this hasn’t happened in a few years (knocks wood) it’s really bad, it’s diazepam and ibuprofen- and heat.
I’d been given a script for Neurotinin, but I was supposed to take it daily whether I had pain or not, and it was like being hit in the head with a ball peen hammer- I couldn’t function. So, I went with the Valium because it, too, works along nerve paths and it didn’t seem to do anything to me except allow me to move around easily.
Others like ice therapy, or a heat then ice approach. Some folks try massage, with good results- at least it feels good for awhile, eh? Acupuncture has a small success rate, and a TENS unit may help, too. You’re going to have to try a few things until you figure out what works for you.
If you are still in the acute phase, you also need to know this is going to take some time. Your sciatic nerve has been insulted and is pissed right off- it isn’t going to calm down in a heartbeat. So, go with what you know usually works for you, pain-wise, and then branch out until you hit the combination that solves the problem.
Hopefully, that’s soon.
I think most folks have covered this well. NSAIDs, acetominophen, gabapentin, pregalbin, capscaisin are all non narcotic pain relievers and work in different ways. So as you can imagine the medication and dosage have to be tailored to the patient. Steroid injections may also be offeredPhysiotherapy,aquatic therapy, acupuncture, meditation ,visual imagery, all may help.
For chronic pain narcotics are probably the last resort, but a “rescue” dose of a narcotic may help when the pain is exacerbated and acute .
However effective medication for helping manage acute and long lasting pain is cannabidiol-CBD with no THC in the form of oil can give long acting pain relief 5–7 hours and a Vape pen ,(inhaled ) CBD will give relief starting in minutes, but lasts a shorter time.. CBD has virtually no effects on alertness, there is no “high” or psychoactive response, in fact apart from pain relief one may not be aware it’s been taken.
Medical marijuana is extremely valuable in several conditions and if given as CBD is very unlikely to be abused. Medical marijuana has got a bad reputation for many people as there is no doubt that some try and scam the system. They want THC just for the psychoactive effects, but CBD can be useful in pain management and many patients end up decreasing considerablythe amount of narcotics they take as the CBD does the job well.
A good pain clinic will help with the management and anyone with chronic pain should ask to see a doctor who specialises in this.
Sciatica is a term used for pain starting in the lower back or buttock and radiating (spreading ) down the leg. The pain is generally describes as electric shock ,burning, sharp or cramp like. It is a type of nerve pain and is often accompanied by other symptoms such as tingling sensation, numbness, weakness of legs and difficulty in weight bearing or walking.
The cause of sciatica pain can lie in the spine or outside the spine (for example when the nerve is compressed by the piriformis muscle in the pelvis). Removing the pain generating cause, such as a disc bulge compressing on the nerve, can help in effective resolution of pain. Depending on the problem- non surgical (such as injections- nerve root blocks, epidurals, piriformis injection etc) and surgical options may be considered as a management option.
Now coming to the your question of the best pain killers- medicines collectively known as neuropathic pain killers are generally used. This group includes medications such as antidepressants and anticonvulsants. These medications are well known painkillers and are used for different types of nerve pain. They generally take a few weeks for the full effects to become apparent. The evidence base behind some of them has been questioned in some recent studies but they are good options to consider and are supported by the NICE guidelines from UK. If there is back pain along with sciatica then some other options such as anti-inflammatories and weak opioids may be considered by your treating doctor. All these medications are to be used under supervision of your treating doctor and he/she may be able to suggest the medicine which are likely to help you most and cause the least side effects.
Hope you find this information helpful. Good luck
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The best pain killer might not be a pain killer
Sciatica, also known as lumbar radiculopathy, is a pain that was originally described as originating along the sciatic nerve. The sciatic nerve is the primary nerve of the leg and is also the largest nerve in the entire body.
Your tolerance for specific medications, procedures, or therapies is one of the important factors that determines your course of treatment.
What about nutrition?
Nutrition offers practical nondrug strategies for people in pain. For an example, Magnesium and vitamin D can reduce perception of pain and some B vitamins fuel the neurotransmitters that put the brakes on pain
Your action plan
When you no longer have acute pain, you may be ready for gentle strengthening exercises for your stomach, back, and legs, and perhaps for some stretching exercises. Too little activity can lead to loss of flexibility, strength, and endurance, and then to more pain.
Many factors can affect how someone responds to medicine or exercise. Genetic variation can be a significant factor in how medicine and exercise impact your health. If you’ve done a DNA test, you can discover how you process medications for free or understand your muscle composition.
Disclaimer: The information presented in this article is not medical advice and it should be treated as such.Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.
Pain killers address the SYMPTOMS! They do not solve the problem…
This can be compared to a cars ‘Check Engine’ Light… If the light comes on the dashboard of your car, would you simply cut the wire to the light?
NO! You fix the problem, and hopefully before you have a breakdown!
The best solution for sciatica (and most disease) is PROPER NUTRITION!
85% of all arthritis is called “wear and tear” arthritis caused by osteoporosis of the joint ends of the bone.
You are talking about degeneration arthritis, osteoarthritis, sciatica, lumbago, rheumatism all sorts of things and…
They are all caused by a CALCIUM deficiency!
As well as a BORON deficiency…
Lower back pain is usually a result of severe osteoarthritis of the vertebrae, but
It severely IMPACTS the discs when you have a COPPER DEFICIENCY!
When you are copper deficient your bodies elastic fibers begin to break down. When they breakdown, they blow out like a balloon under pressure!
For myself, a nerve block has been most successful for my chronic sciatica issues. For occassional flair-ups a cold compress, muscle relaxant and aleve work best. Sometimes I alternate hot and cold for some relief.
It’s frustrating that even in the ER, nerve pain is treated like muscle pain. I’ve been harassed to ‘get up and moved around, you can’t baby yourself cause it’ll get worse!’
What has been essential is appropriate physical therapy. Over the years I got into some very bad habits in the anticipation of pain. My gait, how I moved, how much I lifted—everything was to avoid re-injury and strain. Ultimately those efforts weakened my core especially and made everything else worse. Once that was corrected, things were markedly better.
I just had my second nerve block. I’m hoping it will last as long as the first, which was about 10 months. For my part, during this past winter I slacked off on doing my physical therapy exercises and I believe that caused issues. I have to stay committed in order to feel my best.
ok, good question.
If you read all the educative and good answers above, do you have a clear one/two word answer to your simple question?
I guess not. I’ll tell you why. Your question is like asking is Nike better than Adidas?
As we are not robots who have exactly similar (physical) constitution, our bodies (and nerves) are likely to respond differently to each nerve pain medication. What is good for the goose is NOT good for the gander in case of nerve pain medication.
What I have done is a research on a specific nerve pain medication called Gabapentin (Neurontin) as a case study for a typical pill so that it’s very easy to get a specific answer to the question about best nerve pain killer pill.
You need to clearly understand how a nerve pain pill works in simple English to decide which one is most suitable for you. Read the stuff and eliminate the guess work:
Here you go >> How typical nerve pain medication like Gabapentin works
Once you go through that, let me know via reply if you have a better understanding of nerve pain medication or not.
Medications that we commonly use include anti-inflammatories, muscle relaxants and in more severe or persistent cases, narcotic pain medication, antidepressants or anti-seizure meds. Over the counter medications such as acetaminophen, ibuprofen or naproxen can be used first and are often effective. Sciatica usually affects only one side of the body. Sciatica can be acute or chronic. An acute episode may last between one and two weeks and usually resolves itself in a few weeks. It’s fairly common to experience some numbness for a while after the pain has subsided. Go to my Profile and you can find all Sciatica material there…
What are the best pain killers for sciatica nerve pain?
The best pain killer is the one that controls your pain effectively, and it may not be the same for everyone with your type of pain. I agree with Jae Starr about the need to experiment.
If the sciatic pain is of recent onset, a narcotic pain reliever may be helpful short-term. If the pain is chronic, you’ll get more effective results using an anti-inflammatory pain reliever.
If you are not being treated by a chiropractor, consider consulting one. Chiropractors deal with sciatica a lot and tend to get good results in treating it.
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