Sciatica is the term for pain that results from injury, inflammation, or compression of the sciatic nerve. It is typified by lower back discomfort that radiates to the lower leg or even to the foot and toes in a dermatomal pattern (posterior leg). Most sciatica episodes are caused by compression of the lumbar nerve root. Other functional restrictions and sensory complaints like tingling or numbness are typically linked to it.
The FDA has approved gabapentin for the treatment of post-herpetic neuralgia and seizures. Since little data supports the use of gabapentin for acute sciatica pain, this article focuses exclusively on this topic.
What is Sciatica?
Multiple bones, or vertebrae, divided by discs make up the spine. The discs shield the vertebrae by acting as shock absorbents. Known as a herniated or slipped disc, these discs have a jelly-like core that can spill out with age or damage. Sciatica, which can cause mild to severe pain in the lower back and down one leg, along with tingling and numbness, is most commonly caused by herniated discs.
Risk factors for Acute Sciatica
A-Individual Characteristics
- Peak age: 45–64 years old
- Height smoking raises the danger.
- Stress in the mind
Factors Related to the Workplace
- Excessive physical exertion, such as lifting frequently, particularly when bending and twisting
- Driving while experiencing total body tremor
Diagnosis of Sciatica
The primary methods for diagnosing sciatica are history-taking and physical examination. By definition, patients report leg pain that radiates. They might be asked to describe where the discomfort is located and whether it radiates below the knee. The distribution could then be assessed using drawings. Radiating pain with a dermatomal pattern is a hallmark of sciatica. Additionally, patients may suffer sensory problems.
Treatment Medications for Sciatica
Tylenol, corticosteroids, and anti-inflammatory drugs like ibuprofen or naproxen (NSAIDs) are the first-line treatments for sciatica. You may also be prescribed a muscle relaxant because sciatica can occasionally be accompanied by back spasms that exacerbate the discomfort.
A combination of gabapentin and NSAIDs (naproxen or ibuprofen), corticosteroids, and Tylenol can be highly useful in reducing sciatica and muscle spasms if these medications are unable to adequately relieve pain. Given the possibility of sleepiness, bedtime is the best time to administer. Making the patient more comfortable and improving their quality of sleep at night could be an extra advantage.
Read Also: Unbearable Tooth Pain: What to Do at Home
What is Gapabentine (GBP)?
The prescription drug gabapentin is categorized as an anticonvulsant or anti-epileptic. The FDA has approved gabapentin for the following purposes:
- Seizures: It can be used in conjunction with other medications to manage epileptic seizures.
- Postherpetic neuralgia: Intense blisters brought on by the herpes zoster virus reactivating (shingles)
Off-label Uses Consist of:
Nerve discomfort: Addresses the intense, burning pain in the nerves that is frequently felt after a shingles attack, diabetes, or a spinal cord injury.
Controls the unpleasant feelings that are frequently associated with restless legs syndrome.
Fibromyalgia: Could help alleviate the excruciating symptoms of fibromyalgia
Gabapentin works best for patients with diabetic neuropathy or sciatica, which causes nerve pain, numbness, and tingling in the legs. It can reduce pain signals to the nerves.
Available Dosage Forms
Gabapentin can be purchased in various forms, including pills, oral solutions, capsules, and extended-release tablets. It is available in 600- and 800-milligram pills, Grace tablets, and capsules containing either Neurontin or Neurontin.
What is the Normal Dosage of Gabapentin for Nerve Pain?
For most people, the initial dosage of gabapentin for sciatic nerve pain is 300 mg once daily. The dosage may be increased up to three times each day.
What is the Lowest and Maximum Dosage of Gabapentin for Nerve Pain?
Depending on their individual needs, some patients may be prescribed lesser dosages of gabapentin, although the standard starting dose for nerve pain is 300 mg daily. Though it can vary according to individual response and tolerability, the highest dose is typically up to 3,600 mg daily.
Read Also: How Does Chronic Pain Affect the Brain
How Long Should I Take Gabapentin for Nerve Pain?
In general, gabapentin should be used for at least four to six weeks, or at least two weeks at the greatest dose that can be tolerated. On the other hand, nerve pain may last for three months or more. Your doctor could advise you to keep taking gabapentin every day if it helps.
Summary
Gabapentin might be a good drug to use if you have nerve discomfort. Finding out if it works for you, though, can take some time. It may take many weeks for the drug to start working as intended. It could take even longer for certain folks.
References
- Giménez-Campos, M. S., Pimenta-Fermisson-Ramos, P., Díaz-Cambronero, J. I., Carbonell-Sanchís, R., López-Briz, E., & Ruíz-García, V. (2022). A systematic review and meta-analysis of the effectiveness and adverse events of gabapentin and pregabalin for sciatica pain. Atencion primaria, 54(1), 102144. https://doi.org/10.1016/j.aprim.2021.102144.
- Koes, B. W., van Tulder, M. W., & Peul, W. C. (2007). Diagnosis and treatment of sciatica. BMJ (Clinical research ed.), 334(7607), 1313–1317. https://doi.org/10.1136/bmj.39223.428495.BE
- Bates, D., Schultheis, B. C., Hanes, M. C., Jolly, S. M., Chakravarthy, K. V., Deer, T. R., Levy, R. M., & Hunter, C. W. (2019). A Comprehensive Algorithm for Management of Neuropathic Pain. Pain medicine (Malden, Mass.), 20(Suppl 1), S2–S12. https://doi.org/10.1093/pm/pnz075.
- Wiffen, P. J., Derry, S., Bell, R. F., Rice, A. S. C., Tölle, T. R., Phillips, T., & Moore, R. A. (2017). Gabapentin for chronic neuropathic pain in adults. Cochrane Database of Systematic Reviews, 2017(6), Article CD007938. https://doi.org/10.1002/14651858.CD007938.pub4.
