The main goal for most of the medicines used for sciatica is to lower the pain and decrease the irritation. Although it may look that the medicines are curing sciatica, but they actually do not fight the primary cause. These medicines react with alcohol or other medicines and leave back harsh side effects. So before you buy the medications, refer to a doctor.
This drug primarily works by easing the inflammation in affected tissue and decreases pressure around the sciatic nerve. NSAIDs or Non-steroidal anti-inflammatory drugs which include aspirin and ibuprofen are most popular quick treatment for sciatic pain. It is also prescribed by the doctors in the first place. Also they do not leave any major side effects. However this should not be taken by patients already suffering from stomach ulcer, kidney malfunctioning. High BP and asthma patients must consult doctor before taking this medication. Some other NSAIDs used for sciatica are: ibuprofen, cyclobenzaprine, diclofenac, ketoprofen, phenylbutazone etc. For e.g., Diclofenac is advised for inflammation in lower back, buttock, hip and legs. Kindly note, this is a short time treatment for acute sciatica. Long term increases the chance of heart attack.
Other than heart attack, NSAIDs may cause bleeding in the digestive system, and also can cause stomach ulcers. So never have NSAIDs in empty stomach. Short term decreases the kidney functionality and long term may lead to kidney and liver damage. It can also cause skin rashes/bruises, swelling, constipation or diarrhea. Dizziness and headache are most commonly reported side effects.
Intravenous or Injected NSAIDs
This is generally used in acute cases where the patient needs immediate relief. It is given through an IV drip (intravenously) or injected near the sciatic region to provide fast short term relief. Meloxicam or ketrolac are generally given intravenously or injected, and sometimes in form of tablets to ease the pain and inflammation. This kind of treatment is for five days. However, long term usage of NSAIDs can have harsh side effects. So, these injections are provided in hospitals, under guidance. Patients suffering from high BP, kidney or heart problems should not take this treatment.
Apart from the regular side effects of NSAID tablets, intravenous or injected can have higher complications:
Skin rashes, water retention and swelling had been reported common among the patients treated with intravenous or injected NSAIDs. Severe bruising and fluid may be found in lungs in case of asthma patients. Some have reported tremors, hallucinations and convulsions. Kidneys are more severely damaged in this case compared to other NSAIDs, can also lead to kidney failure. Digestion or stomach related problems are common and sometimes intestinal bleeding may also occur.
These are more related to traditional NSAIDs, which are used to treat sciatica. It also has no gastric effects which is common among NSAIDs. However, due to heart risks, coxibs (valdecoxib – Bextra, rofecoxib – Vioxx ) were taken out. Additionally it can cause stomach ulcer and intestinal bleeding. Celecoxib, similar to other coxibs has much higher risk of heart attacks.
Aspirin – NSAID
Acetylsalicylic acid or Aspirin is one of the traditional pain relieving medications which contains salicylic acid. Aspirin can counter both pain and inflammation. It is not in the same class as the NSAIDs. Let us know how it works. Aspirin tries to increase blood flow in the affected region by diluting the blood. It also restricts pain signals and reduces the inflammation. Though this is gentle medication, it can have some side effects when used for longer term or higher usage. Similar to the above NSAIDs, you may experience stomach problems like ulcers, and nausea. However, aspirin will not affect your kidney in short term usage. Larger dosages may cause tinnitus and anemia.
One of the least harmful medications used during gentle pain is paracetamol. Also known as acetaminophen, it has been the first treatment, before NSAIDs, against sciatica. Although it is not as active as NSAIDs against inflammation, but it is much as safer than the former. It is safe for patients with kidney related problems. Nevertheless it is not considered as NSAIDs. Sometimes it is mixed with other NSAIDs like ibuprofen and codeine to make it more effective in acute cases. It has only side effects when used for a long term or over usage. It may hamper liver, kidney and stomach. Although it is considered as safest among the sciatica medications, it is not as powerful when compared to NSAIDs. So in some case acute sciatic patients may have to opt for NSAIDs.
Narcotics like opioids and opiates, produced from opium poppy can be used to treat acute case of sciatica.
Opioids -, hydrocodone, oxycodone, oxymorphone
Opiates – morphine and codeine
Opioids and opiates relieve the nerve by decreasing the pain perception of the brain. It also increases the tolerance of human body towards pain. But unfortunately they do not have any effect on inflammation. To reduce the inflammation it is combined with ibuprofen, aspirin and acetominophen. Although its good response against sciatica, it is banned in many countries as it can be addicting and will not be available without proper reason and prescription. Morphine must be avoided if the patient has already kidney related problems.
People under Narcotics treatment may face many more side effects. This includes vomiting, nausea and constipation. It also affects the body’s immune system, which in turn makes your body an easy prey for virus and bacterial infections. Some people have reported headache, drowsiness and depression. The feeling after taking the medication may be addictive as human body becomes tolerant and you may need higher dosages for countering the same pain. Even the withdrawal effect can be severe, if it gets addictive.
Tramadol was developed as a substitute for opium that can be used against sciatica without having the common side effects of NSAIDs like gastric and stomach related problems. But still many patients have reported to have similar side effects. It is often prescribed for treating fibromyalgia and arthritis pain and works in the same fashion as opium. However, it doesn’t compromise with the immune system making it much less vulnerable to bacteria and viruses. Like opium it is restricted in many countries and will not be available without a proper reason and prescription at the counter.
Reported side effects of tramadol:
Common side effects are extremely itchy skin, vomiting, nausea and constipation, drowsiness, seizures. The body may become dependent on the medicine, if not addictive, and can have serious withdrawal effects if removed abruptly.
Nortriptyline or amitriptylines were the initially tricyclic antidepressant which showed positive response in chronic pain and long term neuropathic pain. Although it had many side effects, the patients were not depressed and showed positive outcomes. However recent advancement has raised uncertainty about its effectiveness when its overall aspects have been considered, i.e., it’s positive and negative sides.
Several of its side effects are:
- Vomiting, nausea and constipation are very ordinary.
- Difficulty in urination, strain on kidneys.
- Anxiety, drowsiness, confusion are also common. Apart from this patient may find difficulty in thinking.
- Blurred vision and dizziness are also experienced in some cases.
- Withdrawal symptoms can also be severe if stopped suddenly.
Muscle relaxants like diazepam, cyclobenzaprine, methocarbamol and carisoprodol are used to relax muscles. Sometimes it is no easy to diagnose the cause of sciatic pain. Muscle relaxants can be used that time. However studies about muscle relaxants have been unconvincing. Nevertheless they provide slight relief from pain which compensate addiction and drowsiness. Sometimes there may be a risk where the patient can get addicted to feeling. In long term it might lose its effectiveness. People already having kidney and liver disorders should not take this medication and so are people who suffer from depressions.
Side effects of muscle relaxants:
Vomiting and nausea are very common. Some people have severe itching, while few have reported headache, dizziness, poor coordination, headaches, balance problems, depression, drowsiness and fever. These relaxants can be addictive as the patient may like the euphoric (high) feeling. The patient may also get dependent on it for good sleep. When used for long term, the regular dose may seem not to work and the patient goes for a higher dose. This is due to the tolerance of human body. Abrupt withdrawal effect may also be severe.
Traditionally developed as an anti-epiliptic drug, gabapentin can also work for nerve (neuropathic) pain and sciatica. Fibromyalgia, pregabalin are given for short time treatment for sciatica. These drugs work by reducing or restricting the pain intercept by the brain. When the patients undergoing this medication were interviewed it was noted that it works with back pain but not much effective with spiking, sharp sciatic pain.
Various side effects of taking pregablin and gabapentin:
The most common is skin swelling and fluid retention. Apart from these, the patients have experienced mood disorders, drowsiness and weight gain (in long term usage). They have also reported loss of co-ordination and dizziness. If you are continuing with gabapentin, there are chances you can get addicted or dependent on it. You may notice the effect when you did not take a regular dose. Also if you abruptly remove the medication, the withdrawal symptoms can be very painful.
Corticosteroid epidural injections
When a little of anesthetic is mixed with corticosteroids and injected in the affected area of sciatic nerve, it can work well for reducing the inflammation. Methylprednisolone, dexamethosone or prednisolone are often prescribed as injection to treat sciatica. Recommended for only one or two months of treatment, epidurals are used only in acute case of sciatica due to spinal damage. They can provide good short term relief to the patients from sciatica.
Side effects of taking such injections:
The patient can feel dizziness and low pressure. Depression, drowsiness and blurred vision are common with the injection. Also the muscles in contact with the site of injection can become numb, weak and lose functionality.
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