Medicines and products for sciatica

Medicines can ease sciatica pain while the nerve settles, and help you stay active. The choice depends on how severe the pain is, your other health conditions and whether the nerve is weak. Use medicines under medical advice, particularly for more than a few days.

Simple pain relievers

• Paracetamol for mild to moderate pain.
• NSAIDs such as ibuprofen or naproxen for short periods. They can irritate the stomach and affect kidneys, blood pressure and the heart, so avoid them if you have ulcers, kidney disease, heart disease or are pregnant, unless a doctor agrees.

Medicines for nerve pain

• Gabapentin or pregabalin and some antidepressants such as amitriptyline or duloxetine may be prescribed for burning, shooting nerve pain. They can cause drowsiness and dizziness.
• Their benefit in sciatica is modest, and doses must be set by a doctor.

Muscle relaxants Short courses may help muscle spasm. They can cause drowsiness and should not be used with alcohol or when driving.

Steroids Short oral steroid courses are sometimes used for severe pain, with limited evidence and risks. Epidural steroid injections can give short-term relief for pain caused by a herniated disc, in selected people, and are given by a specialist.

Opioids Strong painkillers are not recommended for routine use because of side effects and dependence.

Topical products Heat patches, diclofenac gels and lidocaine patches may bring local comfort.

Surgery Discectomy or decompression surgery is considered for severe or persistent pain, or for weakness and cauda equina symptoms.

Vitamin B12 Prescribed if a blood test shows deficiency.

Ayurvedic view (interpretive) Herbal formulations such as guggulu preparations are used traditionally, but evidence is limited, and some may interact with medicines. Tell your doctor.

Remember Take medicines at the lowest effective dose for the shortest time. Seek urgent care for leg weakness or bladder or bowel changes.