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Gabapentin for sciatic nerve pain
Sciatica symptoms started in my left buttock and left leg in Feb. 2013. I tried weeks of physical therapy, heat & cold therapy, chiropractic spinal manipulations, and a couple of epidural steroid injections with no help. An MRI indicated lumbar bone spurs and two bulging discs - SAID to be likely causes of my compressed sciatic nerve roots. I had laminectomy / discectomy lumbar surgery around the lower two discs on Oct. 10, 2013. A morphine drip immediately after surgery and narcotic oral "Percocet" (325 mg 2 daily) stopped the surgical and sciatic nerve pain until Oct. 13 when nerve pain was again first noticed. It eventually became a little worse than before surgery. I replaced the "Percocet" with NSAID Naproxen (two 220 mg tabs daily) on Oct 21. The orthopedic, back-specialty, surgeon prescribed a "Medrol" steroid oral dose-pack but it gave no relief. By the end of Oct., I had also developed a moderate lower back ache, in addition to the sciatic nerve pain (down to the outside of my left calf). The nerve pain becomes severe after about 5-minutes of standing, eventually making walking impossible. Luckilly, I get relief from sitting or reclining for 10-minutes or more. Leaning against a wall, while taking the load off my left leg, extends the time before severe pain develops. The surgeon prescribed narcotic "Norco" (325 mg 2 daily), which I started Nov. 8 but it gave with no relief. I went back to Naproxen on Nov. 20, which lessens but doesn't STOP the pain. The same day, my surgeon prescribed 300 mg Gabapentin (3 capsules daily). The first capsule made me stumble like a drunk sailor, apparently worsening my pre-existing ataxia, so I took no more and doubled the Naproxen to 2 tablets twice daily.
My surgeon wanted to do another lumbar MRI. I decided to instead ask my PCP for a pain med. He said I had previously started with too much Gabapentin and had me start with 100 mg/day, to give my body time to adapt, and increase in increments. I continued Naproxen and started Gabapentin Jan. 7. By Feb. 8, I had increased the dosage to 700 mg per day, 100 mg in the morning and 300 mg in the afternoon and at bedtime. I'm discouraged by the fact that my nerve pain has NOT been reduced yet but the unsteadiness is worse, to the point of nearly falling during walking! I'm having to be very careful!
I have two questions. (1) Given that 700 mg daily has not reduced my sciatic pain AT ALL, is there any reason to believe that increasing dosage will ever stop the pain? (2) Is there any reason to believe that the serious unbalanced side-effects will end at 700 mg and at higher dosage needed to stop the pain?