Sciatica is the sensation of pain, tingling, or burning running along the course of the sciatic nerve, which extends from the lower back down into the leg. The pain can occur due to contact or compression of the sciatic nerve, and commonly can be caused by a slipped disc. The specific location of the pain or altered sensation is dependent upon the nerves that are irritated or compressed. Sciatica often resolves on its own, but pain may be managed with non-drug treatments and painkillers. The best painkillers for your sciatica will often depend on the severity and intensity of the pain as well as other factors.
Taking things easy, and resting for the first few days can help to relieve pain brought on by an acute episode of sciatica. If sleeping is difficult, try some altered positions like having a pillow under your knees if you sleep on your back. Or if you are a side sleeper, try with a pillow between your legs, or under your hips.
After this initial period of rest, staying as active as possible with appropriate pain relief, and introducing gentle exercise is important for recovery. This means going about your day-to-day activities as normal if you can. Alternating between hot and cold compression of the area affected may also help to relieve discomfort, especially muscle spasms associated with sciatica. Seeing a licensed chiropractor or physiotherapist is usually helpful.
Painkillers are useful for treating pain and at helping the recovery of sciatica. Paracetamol is usually a safe and sensible place to start when reaching for painkillers, with relatively few risks or side effects if taken as instructed. It’s well-tolerated and may be sufficient for mild-moderate pain.
Non-steroidal anti-inflammatory drugs (NSAIDs) are particularly useful at treating back pain and sciatica, it is class of medications that work on pain and dampen down inflammation. Examples include ibuprofen, naproxen and diclofenac.
Oral paracetamol and ibuprofen and topical ibuprofen and diclofenac are available to buy from any pharmacy, but stronger NSAIDs such as naproxen need a prescription. If after using paracetamol or ibuprofen individually, try using them in combination. This will allow you to cover periods where the painkillers may wear off or add the extra layer of pain relief as they work differently in the body.
If after trying a combination of paracetamol and NSAIDs, you are still experiencing pain, you can try using a mild opioid combination such as co-codamol or co-dydramol as a replacement for paracetamol, which can be bought behind the counter in a pharmacy. This contains paracetamol and small amounts of codeine or dihydrocodeine. This is only for short term use, therefore if symptoms are still experienced after treatment with opioid painkillers for a few days, then you should speak to your doctor.
Side effects of opioid family of medications include constipation, drowsiness and feeling dizzy, sick or slightly “out of it”. Certain people seem more susceptible to this than others.
If you find this is still not cutting it, and you are needing stronger painkillers than co-codamol, you should probably be seeing your doctor about your back pain – especially if it is the first time it has occurred. Your doctor will be able to examine you, and prescribe other medications which can help with the pain.
Sciatica usually resolves itself by 6-12 weeks, with the worst of the pain starting to improve over the first few weeks. If your pain is not improving after a few weeks despite care and exercise at home, if the pain is severe or getting worse, or if it is affecting your daily activities, you should see your doctor to discuss this. Concerning signs that suggest you should book an urgent appointment with your doctor are lack of control when peeing or pooing, numbness around the buttocks and back passage, numbness in your legs, weakness of your lower legs, fevers or other severe symptoms that feel out of proportion with the problem.
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