Medicines for the Treatment of Sciatica

Definition

The term "sciatica" refers to a pain that s "radiates along the sciatic nerve and its branches, as well as in the back, buttocks and legs: more precisely, sciatica is also called sciatica, in reference to a" load of the sciatic nerve. There are numerous variants of sciatic pain, the differentiation of which must be carried out according to the etiopathological triggering agent.

Causes

The causes of sciatica are various and heterogeneous: the pain of the sciatic nerve can result from some incorrect postures prolonged for long periods, but also from stress, physical or even psychological problems. Disc herniation is one of the most common causes of sciatica.

Risk factors: arthritis, pregnancy, spinal infections, obesity, osteoporosis, spinal pathologies, muscle overstrain, direct trauma to the thighs, buttocks and legs.

Symptoms

Characteristic of sciatica is pain that radiates from the lumbar spine to the buttock and back of the leg. The intensity of the pain varies according to the underlying cause: some patients complain of a constant tingling sensation, others a excruciating pain, still others describe the discomfort as a strong electric shock. Often, the pain intensifies in conjunction with a cough or sneeze; muscle numbness can also degenerate into loss of bladder or bowel control (rare).

The information on Sciatica - Medicines for the Treatment of Sciatica is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Sciatica - Medicines for the Treatment of Sciatica.

Medicines

Treatment for sciatica depends on the cause that caused the pain: it is up to the doctor to decide how to intervene to calm the pain and, when possible, to permanently remove the sciatica. In some cases, forced rest and some small changes in behavioral and postural habits are recommended.
In many patients who suffer from it, the pain deriving from sciatica is minimized with simple practices, consisting both in the administration of anti-inflammatory drugs and in physical-rehabilitative therapy.
The patient can make use of the aid of corsets, crutches and braces, useful for reducing the perception of pain, improving the quality of life of the patient who is affected by it (often indicated in acute episodes of sciatica).
Rehabilitation practices include useful exercises to support the back, correct posture, strengthen the muscles and improve the flexibility of the spine, often made difficult due to the pain exerted on the sciatic nerve.
The herniated disc, as we have seen, is often a predisposing element of sciatica; consequently, the treatment of the herniated disc will consequently also lead to the removal of sciatic pain.
In parallel with rehabilitation therapy, it is recommended to contact specialist massage therapists, physiotherapists, osteopaths or chiropractors (alternative therapies). Ultrasound therapy has also been gaining ground in recent years for the treatment of pain associated with sciatica.
When sciatica is very severe, and therefore degenerates to the point of compromising the functionality of the bladder or intestine, surgery (discectomy or microdiscectomy) is conceivable.
In most affected patients, the herniated disc is treated with pain relieving drugs such as acetaminophen, NSAIDs or cortisone. Let's see in more detail.

The following are the classes of drugs most used in sciatica therapy, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:

Ibuprofen (eg. Brufen, Moment, Subitene): for medium-moderate pain, it is recommended to take by mouth a dose of active equal to 200-400 mg (tablets, effervescent sachets) every 4-6 hours after meals, at need. Do not take more than 2.4 grams per day.
Naproxen (eg Aleve, Naprosyn, Prexan, Naprius): it is recommended to take the drug at a dosage of 550 mg, orally, once a day, followed by 550 mg of active ingredient every 12 hours; alternatively, take 275 mg of naproxen every 6-8 hours, as needed. Do not exceed 1,100 mg per day.
Diclofenac (eg Voltaren): available in the form of a gel, gastro-resistant tablets, suppositories or solution for injection. For topical application, it is recommended to spread a layer of cream in the area affected by sciatica twice a day. For tablets, take 50 mg of the drug orally 3 times a day; in some patients, one dose is required. starting of 100 mg, then passing to 50 mg. After the first day, the total daily dose should not exceed 150 mg. Diclofenac is often found in combination with other active ingredients aimed at creating a protection for the stomach, given the marked gastrolesivity of many non-steroidal anti-inflammatory drugs such as diclofenac. For example, the combination of diclofenac + misoprostol (eg Artrotec) is now known: it is recommended to take one tablet (formulated with 75 mg of diclofenac and 200 mg of misoprostol) , twice a day, after meals, with a glass of water. Do not take during pregnancy, breastfeeding and children.
Acetylsalicylic acid (eg Aspirin, Vivin, Ac Acet, Carin): the drug, indicated for adults only, should be taken at a dosage of 325-650 mg orally or rectally, every 4 hours, as needed. Do not exceed 4 grams per day. Giving the drug to children under the age of 12 can cause serious side effects, such as Reye's syndrome, liver dysfunction and brain changes.
Indomethacin (eg Difmetre, Indom, Liometacen): drug used in therapy also for the treatment of sciatic nerve pain. It is recommended to take the drug at an initial dose of 25 mg orally, every 8-12 hours, up to a maximum of 150-200 mg (for immediate release tablets), on a full stomach, after a meal. For slow-release tablets, take 75 mg of active, orally, once a day; for the maintenance dose, the dosage can be increased up to 75 mg, twice daily. The drug is also available as suppositories to be taken rectally: in this case, the expected dose is 50 mg, every 8-12 hours.

Muscle relaxing drugs: indicated for pain control and for the reduction of muscle spasms in the context of sciatica:

Ciclobenzaprine (eg Flexiban) the drug belongs to the class of muscle relaxants; the active principle is widely used in therapy for the treatment of disc herniation. As analyzed several times during the course of this article, disc herniation is one of the causal elements that most often favor sciatica. Therefore, cyclobenzaprine is also widely used for pain control and for the reduction of muscle spasms dependent on sciatica. Start taking the drug at a dose of 5 mg orally, three times a day. Depending on the patient's response, the dosage may be increased to 7.5-10 mg, three times a day. Alternatively, take the drug in the form of slow-release tablets, at a dose of 15 mg or 30 mg, orally, once a day.

Corticosteroids: steroid drug injections are indicated in case of severe sciatica; in particular, the active ingredients are injected directly into the area affected by the inflammation (near the sciatic nerve), to exert a powerful anti-inflammatory effect.

Prednisone (eg. Deltacortene, Lodotra): take 5-60 mg of active orally in 1-4 divided doses over 24 hours. Consult your doctor. Do not continue therapy beyond what is necessary
Methylprednisolone (eg. Solu-medrol, Advantan, Depo-Medrol, Medrol, Urbason): to ensure a moderate immediate anti-inflammatory effect, take 4-48 mg per day of the drug orally. Consult your doctor.

Corticosteroids are not a viable long-term treatment option, given their numerous and conspicuous side effects. The number of injections should be indicated by the doctor and, in general, should be established exclusively for severe sciatic pain.