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Posted on 04-30-2017

Lyrica No Better Than Placebo For Low Back Pain With Sciatica

A recent study out of the New England Journal of Medicine on March 22, 2017 indicates that a widely prescribed drug used against sciatica may be no more effective than placebo. The study found that the amount of improvement that sciatica patients felt was the same whether they were given Lyrica (pregabalin) or a placebo for their back and leg pain. You can read about the study here.

In my Baltimore chiropractic clinics we routinely treat patients that have sciatica. Often these patients are being co-treated by their primary care physicians, pain management specialists, and/or orthopedists for their lower back and sciatic pain. While I am in no way suggesting that patients taking these medications discontinue their use (as Chiropractors we can not advise our patients on the use of medications), I do suggest that in light of these findings sciatic patients should discuss these findings with their medical providers and determine if the continued use of these medications is appropriate.

Sciatica refers to inflammation of the sciatic nerve - a large nerve that runs down the back of the leg. Everyone has two sciatic nerves, one of the left side and one on the right. In some instances patients with sciatica have only pain down the back of their legs. In others, they also present with numbness, tingling, or weakness down their leg in addition to pain. There are many different causes of sciatica, with the most common being irritation of the sciatic nerve such as by a bulging or herniated lower back intervertebral disc.

After studying more than 200 sciatica patients who were randomly assigned Lyrica or a placebo and were followed up over a course of up to eight weeks, the study's author concludes "we do not recommend the use of pregabalin in people with sciatica." Patients originally included in the study rated their sciatic pain at around a 6/10. Following the eight week study, whether participants were given Lyrica or a placebo the average pain score at the end of the study was down between 3 and 3.7 regardless of which pill was taken. It is important to note, however, that those participants that were given Lyrica did report more side effects compared with the placebo group.

These findings are interesting to me and my associate Baltimore chiropractors since we routinely treat patients with sciatica. I typically suggest that patients should try a short course of chiropractic care (2-4 weeks) followed by referral to other specialists for further evaluation and intervention. Corticosteroid injections and/or advanced imaging may be appropriate down the line if a short course of chiropractic care does not help with the sciatica.

If you are experiencing sciatica and would like to try some non-drug and non-surgical efforts to improve or eliminate your sciatic pain please call Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

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