Gabapentin and Pregabalin for sciatic pain

[hosbay]

Has anyone had sciatic pain relief from either gabapentin or pregabalin. Back in 2014 I was on Gabapentin for 3 months for acute sciatic pain and it did not help the pain and it affev=cted ny cognitive faculties like awareness, concentration and memory, etc. I am now trying pregabalin for another bout of very acute sciatica (1 1/2 weeks on 50mg dose) and it too does not seem to be helping the pain.

[Madlegs1]

You really need an anti inflammatory such as ibuprofen available at any chemist or even naproxen, only through a Dr.

These are both hard on the tummy, so be careful. With food and loads of liquid.

There are stretching movements available on YouTube which can also help.

Good luck.

[hosbay in reply to Madlegs1]

Hi Madlegs and thanks for your reply.

I am a long time sufferer with sciatica. The first acute episode was 9 years ago when I tried all kinds of medication for nociceptive pain like Cocodamol and Naproxen for several months and it did not help, I also tried amitriptyline and even morphine sulphate and they did not help. I was also on gabapentine for 3 months and it also did not help the pain although it was offered as the drug of choice for neuropathic sciatic pain. The side effects of the gabapentine affected mental functions like concentration. awareness, etc, I also had nerve root infiltrations and caudal infusions which also did not help. 18 months after the initial sciatic trauma I had an operation to decompress nerve roots and it too did not help. Since then I have been self-managing the less severe chronic symptoms without medication for about 7 or so years.

Unfortunately, I am now in my second acute sciatic episode and, reluctantly, have been trying Pregablin which is a similar gabenoid medication to gabapentin. After one and a half weeks there is no reduction in pain and I am trying to contact people who have tried gabapentin or pregablin to hear how effective they have found it. British Medical Journal has posted results of a fairly extensive study on the use of pregablin for sciatic pain where the conclusion was that it was ineffective for the relief of sciatic pain.

[Madlegs1 in reply to hosbay]

That would be right.

[Nines]

I suffer from sciatica and when I was in hospital I was given liquid morphine and morphine tablets, when I was discharged on prescription. When I have episodes of it now I use muscle freeze spray or voltarol pain relief cream and it helps. I don’t take medication for anything but epilepsy since being diagnosed with it as everything interferes with it but I have been prescribed pregabalin for epilepsy in the past so it really surprised me that you have been prescribed it for sciatica. I hope you get well soon X

[hosbay in reply to Nines]

Yes you are correct pregabalin (and gabapentin)are primarily prescribed for epilepsy but the literature suggests it can help with sciatic pain and, I believe, it is widely prescribed for it. Do you still suffer from the early stage (very acute) sciatica or do you have the more moderate (less pain) chronic sciatica and do you feel the pregabalin eases your sciatic pain?

[Badbessie in reply to Nines]

It is also used in the treatment of fibromyalgia and a number of neurological conditions.

[Nines]

hello, I suffer from the more moderate one now. I was only ever in hospital with it in the beginning. Unfortunately epilepsy causes memory loss so I don’t remember if pregabalin helped with my sciatica I just know it didn’t help the epilepsy and I’ve been on all but two of the epilepsy medications available and still it’s uncontrolled but I will keep my fingers crossed for you 🤞X

[hosbay]

Thanks for your freply Nines. I thought you were probably in the less painful, more manageable chronic phase of sciatica which I was in for several years, Possibly your muscle relaxants may well help in that stage, I never tried them when I was in that stage. Unfortunately in the early acute stage all, or maybe most, of the pain is neuriopathic and not nociceptive which is the normal pain from muscles and tissue, etc. Neverthe less I will try some muscle relaxants and see if that helps.

[hosbay]

So sorry I am too focussed on my own sevee problem, I forgot to wish you luck and hope you find something which helps with your epilepsy.🙏

[Nines in reply to hosbay]

Thank you so much, that’s really kind of you. I use the muscle relaxants on my left leg. Well from my hip down to my ankle and across my lower back because I have sciatica down the left side from my jaw to my ankle and across my lower back and unfortunately a bent spine X

[hosbay]

Should have asked you which muscles you find the muscle relaxants work on.

[hosbay]

Have you tried serotonin reuptake inhibitor medication for your epilepsy?

[Nines in reply to hosbay]

Hi, no I haven’t heard of it. I’ve had a VNS stimulator but I reacted badly to it so it’s since been removed and I’m always so reluctant to try anything new because of how I was treated by the NHS in the past and that was before covid so I can’t help but think it would be so much worse now. Is it supposed to be a good medication for epilepsy? The doctors haven’t got to the cause of my epilepsy just that it’s damage to the left temporal lobe and I have a lump on the right side which could be an early sign of Alzheimer’s and my Nan had it so it wouldn’t surprise me X

[hosbay in reply to Nines]

Hi Nines I have had another look at SSRIs and they say they are really an anti depressants which are safe to use for people who suffer fro epilepsy. Sorry for the misinformation.

[Nines in reply to hosbay]

That’s ok, thank you for trying to help I appreciate it. X

[Badbessie]

The medication you mention can help however its effects are varied. The question I would be asking is the cause of the sciatica. Could physiotherapy help? The cause of sciatica can range from osteoarthritis to soft tissue damage such as a prolapsed disc. Have you had any tests scans etc to find out the cause?

[Mitch48]

I’ve extensive complex cervical & lumbar spinal injuries with cervical & lumbar radiculopathies causing severe chronic pain, mobility problems, etc, etc. I have had several surgeries with numerous procedures for common & rare conditions of the spine. I have been on Gabapentin for nearly 20 years (I’m 53), I tried Pregabalin briefly but the weight gain (1.5 stone in 7 weeks!) was too much of a side effect for me to tolerate.

You are on a very low dose of Gabapentin & need to take it for longer in the first instance, these drugs can take a while to work & ask your GP to raise it if there is no improvement should you wish. Also consider ibuprofen if you can take it.

I have taken the maximum dose of 3600 mgs daily but am currently on 2700 mgs along with a huge list of other medication including strong opioids such as Fentanyl patches, Oramorph, Naproxen, Baclofen , Duloxetine, etc. These drugs & their dosages are because of the extensive arthritis, nerve damage & the length of time that I have been injured along with finding my maintenance dose for each drug. I still feel severe breakthrough pain for most of the day/night, there is no wonder drug for spinal injuries & a spinal cord stimulator is not suitable for my conditions.

Be patient & try self help such as a Tens machine - brilliant little things for helping to cover some of the pain or all. A massage gun for muscle spasms that will no doubt be contributing to your pain, cold spray, hot baths, stretching is fabulous for sciatica, there are plenty of videos online, mindfulness, Yoga the list goes on. Also keep moving as sitting down all day, especially in a wrong position can compress lumbar nerves making more pain.

Good luck.

Mitch .

[hosbay in reply to Mitch48]

Sorry to hear about your problems Mitch you have my sympathies.

My original acute sciatic trauma 9 years ago was probably a radiculopothy in the L4/L5 or L5/S1 region of my spine probably caused by over-strenuous activities and MRI scans did not show nerve root compression then. As I said I had all kinds of medication, injections and operation to try to resolve the symptoms but it took years (without medication, etc) for the symptoms to reduce to a manageable level. For the last few years I have been self-managing my condition with avoidance, pacing exercise, mindfullness, etc, without any medication.

5 years ago I was referred to Pain Management and the consultant said I would get a spinal chord stimulator (scs) I eventually had a trial scs in April of this year but it was not permanently fitted because the surgeon said my nerves were too damaged and it would be ineffective. Before the trial scs I had an MRI scan in 2020 which showed that two spinal nerve roots were now permanently compressed. 6 weeks ago I unfortunately ended up at the debilitating acute sciatica stage again after all these years. I have another MRI scan tomorrow and see a neurology surgeon next Tuesday but I do not think that the diagnosis and prognosis will be good. As I said in an earlier post I was on high strength Gabapentin for 3 months 9 years ago. It did nothing for tyhe pain and had pretty bad mental side effects. Because of this I was very reluctant to try a gabenoid again but, thinking about my condition I decided to try again. I have been taking pregabalin (150mg/day) for the past 2 weeks and it does not seem to be helping the pain and I can feel similar mental side effects to the gabapentin.

The reason for ny initial post was to hear if anyone has been able to assess that they truly have had pain relief from either gabapentin or pregabalin.

[Mitch48]

I’m sorry to hear you’re having your problems too.

Have you ever had Radio Frequency Ablation treatment?

I find it the only pain management treatment that will work on all the types of nerve pain but for me that was only AFTER discectomies & fusion( I’ve had 4 cervical/lumbar etc).

Have you ever obtained neurosurgeon’s opinion? Is that what you mean by seeing a neurology surgeon?

I’m aware that elderly people do have spinal surgery but more widespread arthritis & additional comorbidities can prevent that from being an option.

Let us know what happens with the surgeon please.

Kind Regards,

Mitch

[hosbay]

Hi again Mitch what I really wanted was an MRI to see how much degradation there has been since 2020. I was still able to self-manage my chronic sciatic condition in 2020 when the MRI showed compression on the 2 nerve roots. I have even been managing my condition up to 6 weeks ago. What I really want to know (apart from possible efficacy of Pregablin) is if it will be possible to get back to the situation where I can have a reasonable quality of life by me self-managing the chronic stage again or will the condition of my spine prevent it. I am reluctant to have another decompression operation as the last one in 2016 did not help.

[MSTKing]

I take it as part of other pain drugs - mainly for spasms and other nerve pain.

[momander]

Hi

I have been on gabapentin for quite a few years now and I can honestly say it has really helped me. I tried pregabalin last year and it made me feel suicidal!! I have never had such a severe reaction to any medication as i had to that one. We are all different though, and I know many people who take pregabalin and deal with it very well

[strongmouse]

Hi tried pregabalin and it didn't help. The GP then prescribed me low dose nortryptaline at night and it makes a big difference. Like all medication it doesn't suit everyone, but I find it works well. I've had some physio aswell and that helped to lessen the pain. (It helped to strengthen my core muscles around the spine). I take cocodamol for other pain and that didn't touch the nerve pain. Heat helps if the area around the source of pain is inflammed. I have to be careful with my posture and things like bending or lifting anything, not to aggravate it. When it flares it does take a while to settle down again.

Hope you find something that works well for you.