Several oral and topical medications may help relieve sciatica pain. Learn about the different OTC and prescription drugs that may be helpful for your unique situation.

References

• 1.Berry JA, Elia C, Saini HS, Miulli DE. A Review of Lumbar Radiculopathy, Diagnosis, and Treatment. Cureus. 2019;11(10):e5934. Published 2019 Oct 17. doi:10.7759/cureus.5934
• 2.Nakashima H, Kanemura T, Ando K, et al. Is Pregabalin Effective Against Acute Lumbar Radicular Pain ?. Spine Surg Relat Res. 2018;3(1):61–66. Published 2018 Jun 29. doi:10.22603/ssrr.2018-0003
• 3.Safaeian P, Mattie R, Hahn M, Plastaras CT, McCormick ZL. Novel Treatment of Radicular Pain With a Multi-Mechanistic Combination Topical Agent: A Case Series and Literature Review. Anesth Pain Med. 2016;6(2):e33322. Published 2016 Mar 1. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4886452/
• 4.McAllister R.K., Burnett C.J. (2015) Topical Analgesic Medications. In: Sackheim K. (eds) Pain Management and Palliative Care. Springer, New York, NY doi: https://link.springer.com/chapter/10.1007/978-1-4939-2462-2_15
• 5.Ko S, Kim S, Kim J, Oh T. The Effectiveness of Oral Corticosteroids for Management of Lumbar Radiating Pain: Randomized, Controlled Trial Study. Clin Orthop Surg. 2016;8(3):262–267. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4987309/
• 6.Frontera, Walter R., J. K. Silver, and Thomas D. Rizzo. Essentials of physical medicine and rehabilitation : musculoskeletal disorders, pain, and rehabilitation. Philadelphia: Elsevier, 2019. Print.
• 7.Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2020 Jan 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/

Muscle relaxants have the potential to decrease tension and spasm within a sore muscle, which may help reduce back pain. But these drugs may cause side effects to occur in some people and must be used with caution.

References

• 1.Witenko C, Moorman-Li R, Motycka C, et al. Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low back pain. P T. 2014;39(6):427–435. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103716/
• 2.Chou R, Qaseem A, Snow V, et al. Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine. 2007;147(7):478. doi: 10.7326/0003-4819-147-7-200710020-00006
• 3.Jackson KC II, Argoff CE, Dubin A. Skeletal Muscle Relaxants. In: Practical Management of Pain. Elsevier; 2014:569-574.e1. doi:10.1016/b978-0-323-08340-9.00041-4
• 4.Spence MM, Shin PJ, Lee EA, Gibbs NE. Risk of Injury Associated with Skeletal Muscle Relaxant Use in Older Adults. Annals of Pharmacotherapy. 2013;47(7-8):993-998. doi:10.1345/aph.1r735

While opioid medications are commonly prescribed to help manage pain, long-term use may actually cause an increased sensitivity to pain. Here’s how and potential alternative treatments.

References

• 1.Hayhurst CJ, Durieux ME. Differential opioid tolerance and opioid-induced hyperalgesia: a clinical reality. Anesthesiology. 2016;124(2):483-8. doi: 10.1097/ALN.0000000000000963.
• 2.Yi P, Przbylkowski P. Opioid-induced hyperalgesia. Pain Med. 2015 Oct; 16 Suppl 1:S32-6. doi: 10.1111/pme.12914.

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For most people with back pain, surgery is recommended only after all other options have been exhausted.

A common nonsurgical approach to pain relief is epidural steroid injections, which help reduce inflammation around your spinal cord and spinal nerves. They are primarily intended for temporary pain relief, but steroid injections coupled with therapeutic exercise may allow patients to postpone or even avoid surgery altogether.

References

• 1.Patel K, Upadhyayula S. Epidural Steroid Injections. [Updated 2019 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470189/
• 2. Hassan KZ, Sherman Al. Epidural Steroids. [Updated 2019 May 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK537320/
• 3.Bartleson JD, Maus TP. Diagnostic and therapeutic spinal interventions: Epidural injections. Neurol Clin Pract. 2014;4(4):347–352. doi:10.1212/CPJ.0000000000000043
• 4.Pountos I, Panteli M, Walters G, Bush D, Giannoudis PV. Safety of Epidural Corticosteroid Injections. Drugs R D. 2016;16(1):19–34. doi:10.1007/s40268-015-0119-3
• 5.Knezevic NN, Jovanovic F, Voronov D, Candido KD. Do Corticosteroids Still Have a Place in the Treatment of Chronic Pain?. Front Pharmacol. 2018;9:1229. Published 2018 Nov 1. doi:10.3389/fphar.2018.01229
• 6.Dietrich TJ, Sutter R, Froehlich JM, Pfirrmann CWA. Particulate versus non-particulate steroids for lumbar transforaminal or interlaminar epidural steroid injections: an update. Skeletal Radiology. 2014;44(2):149-155. doi:10.1007/s00256-014-2048-6
• 7.Chang, Douglas, Zlomislic, Vinko. Chapter 273. Lumbar Spinal Injections. In: Chapman, Michael W. Chapman's Orthopaedic Surgery. Philadelphia: Lippincott Williams & Wilkins. https://www.researchgate.net/publication/327034223_Lumbar_spinal_injections_Chapman's_Orthopaedic_Surgery_Chapter_273. Accessed December 23, 2019.
• 8.van Helvoirt H, Apeldoorn AT, Ostelo RW, et al. Transforaminal Epidural Steroid Injections Followed by Mechanical Diagnosis and Therapy to Prevent Surgery for Lumbar Disc Herniation. Pain Medicine. 2014;15(7):1100-1108. doi:10.1111/pme.12450

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