Definition
The term "sciatica" refers to a pain that radiates along the sciatic nerve and its branches, as well as to the back, buttocks and legs: more precisely, sciatica is also called sciatica, referring to an inflammation load of the sciatic nerve. There are numerous variants of sciatic pain, the differentiation of which must be carried out according to the causative pathogenetic agent.
Causes
The causes of sciatica are varied and heterogeneous: the pain of the sciatic nerve can result in some incorrect postures lasting for long periods, but also in stress, problems of a physical or even psychological nature. Disc herniation is one of the most common causative factors of sciatica.
- Risk factors: arthritis, pregnancy, infections affecting the vertebral column, obesity, osteoporosis, pathologies of the rachis, muscle supraforcing, direct traumas to thighs, buttocks and legs.
Symptoms
Characteristic of sciatica is the pain that radiates from the lumbar area of the spine to the buttock and the back of the leg. The intensity of pain varies depending on the cause: some patients complain of a constant tingling sensation, others atrocious pain, others still describe the discomfort as a strong electric shock. Often, the pain becomes acute in conjunction with a cough or sneeze; Muscular numbness can also degenerate in loss of bladder or bowel control (rare).
Information on Sciatica - Sciatica Care Drugs is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Sciatica - Sciatica Medication.
drugs
The treatment for sciatica is subject to 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 minor changes to behavioral and postural habits are recommended.
In many patients who are affected, the pain derived 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 (often indicated in acute sciatica episodes).
Rehabilitation practices include 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 an element predisposing to sciatica; consequently, the treatment of the herniated disc will, as a consequence, also produce the removal of sciatic pain.
In parallel with rehabilitation therapy, it is recommended to contact masseurs specializing in the subject, physiotherapists, osteopaths or chiropractors (alternative therapies). Ultrasound therapy is also gaining ground in recent years for the treatment of pain associated with sciatica.
When sciatica is very severe, so it degenerates to the point of compromising bladder or bowel function, surgery (discectomy or microdiscectomy) is conceivable.
In most affected patients, herniated discs are treated with painkillers such as paracetamol, NSAIDs or cortisone drugs. Let's see in more detail.
- Ibuprofen (eg. Brufen, Moment, Subitene): for medium-moderate pain, it is recommended to take an active dose of 200-400 mg (tablets, effervescent sachets) by mouth 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 an oral dose of 550 mg once a day, followed by 550 mg of active 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 as a gel, gastro-resistant tablets, suppositories or solution for injection. For the topically applied drug, it is recommended to spread a layer of cream in the area involved with sciatica twice a day. For the tablets, take 50 mg of drug orally 3 times a day; in some patients, an initial dose of 100 mg is required, and then changed to 50 mg. After the first day, the total daily dose should not exceed 150 mg. Diclofenac is often available in association 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, it is now known the combination diclofenac + misoprostol (eg Artrotec): it is recommended to take a tablet (formulated with 75 mg of diclofenac and with 200 mg of misoprostol), twice a day, after meals, with a glass of water. Do not take during pregnancy, lactation and in children.
- Acetylsalicylic acid (eg. Aspirin, Vivin, Ac Acet, Carin): the drug, indicated for adults only, should be taken at a dose of 325-650 mg orally or rectally, every 4 hours, as needed. Do not exceed 4 grams per day. The administration of 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, per os, once a day; for the maintenance dose, it is possible to increase the dosage up to 75 mg twice a day. 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 relaxant drugs : indicated for pain control and reduction of muscle spasms in the context of sciatica:
- Ciclobenzaprina (eg Flexiban) the drug belongs to the class of muscle relaxants; the active ingredient is widely used in therapy for the treatment of disc hernia. 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 reduction of muscle spasms due to sciatica. Start taking the drug at a dose of 5 mg orally, three times a day. Based on the patient's response, it is possible to increase the dosage up 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 : injections of steroid drugs are indicated in cases of severe sciatica; in particular, the active ingredients must be injected directly at the level of the area affected by the inflammation (near the sciatic nerve), to exert a powerful anti-inflammatory effect.
- Prednisone (eg. Deltacortene, Lodotra): take 5 to 60 mg of active in 1-4 divided doses during 24 hours. Consult your doctor. Do not prolong the therapy beyond what is due
- Methylprednisolone (eg. Solu-medrol, Advantan, Depo-Medrol, Medrol, Urbason): to ensure a discreet immediate anti-inflammatory effect, take for os 4-48 mg per day of medication. Consult your doctor.
Corticosteroids do not represent a valid long-term treatment option, given their numerous and striking side effects. The number of injections should be indicated by the doctor and, in general, should be established exclusively for severe sciatic pain.
