Treating Sciatica with Medication

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Anti-inflammatories, muscle relaxants, narcotics, tricyclic antidepressants, and anti-seizure medications are some of the options to treat sciatica. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics and Sports Medicine Institute, says doctors will typically treat an acute injury with a steroid pack.

He also explains there is no evidence that muscle relaxers help the patient in the long-term, because it does not treat the source of the problem.

Transcript
THIS IS THE DOCTOR’S CHANCE TO EXPLAIN. > TYPICALLY IF IT IS AN ACUTE INJURY LIKE YOU’RE IN THE VIDEO, IT WILL BE A STEROID PACK. MOST OF THE TIME, THAT WORKS WONDERS. IF NOT, THERE WILL BE A SOUND MEDICATION TO PRESCRIBED LIKE THEY WERE SAYING IN THE CLIP, NAPROXEN, IBUPROFEN. THOSE ARE STANDARD ANTI-INFLAMMATORY MEDICATIONS. THERE’S NO EVIDENCE THAT MUSCLE RELAXERS HELP THE PATIENT IN THE LONG-TERM. NORMALLY THE MUSCLE RELAXANT TREATS THE END RESULT, NOT THE SOURCE OF THE PROBLEM. WE WANT TO GO TO THE ROOT, NOT FOR THE CONSEQUENCE. NORMALLY YOUR MUSCLES, THEY TEND TO STOP — WHEN YOU HAVE AN INJURY, YOUR BODY DOES NOT WANT TO MOVE, SO BASICALLY THE MUSCLE RELAXANT WILL BREAK THE CYCLE, BUT IT’S NOT TREATING THE SOURCE OF THE PROBLEM. WHEN YOU LOOK AT LITERATURE THAT SAYS THAT MUSCLE RELAXANT SHOULD BE USED UP TO 14 DAYS AND AFTER 14 DAYS, THERE’S NO EVIDENCE THE MEDICATION WILL HELP. MUSCLE RELAXANTS LIKE FLEXERIL. WE AVOID NARCOTICS AT ALL COSTS UNLESS THEY ARE IN EXCRUCIATING PAIN. THEY MAY BENEFIT FROM A SHORT COURSE OF NARCOTICS. JUST FOR A SHORT TIME. FOR THE MOST PART, PEOPLE WILL GET BETTER. ANTIDEPRESSANTS — NORMALLY THOSE MEDICATIONS IN SHORT DOSES WILL WORK FOR PAIN AND NORMALLY THEY ARE USED FOR NERVE PAIN. THEY ARE SECONDARY MEDICATIONS FOR TREATMENT OF PAIN. SO IT’S NOT THE INITIAL MEDICATION FOR TREATING THE CONDITION. AND FINALLY, CONDITIONS LIKE LYRIC OR GABAPENTIN — LYRICA OR GABAPENTIN. WE DO NOT WANT TO BOMBARD THE PATIENT WITH FOUR OR FIVE PILLS WHEN THEY COME TO THE OFFICE. WE JUST GO SLOWLY.
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