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Painkilling drug no better than placebo for sciatica

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Sciatica patients are sometimes prescribed a drug called pregabalin for pain relief, but a new study reveals that it is no more effective than placebo. What’s more, researchers found that people taking the drug reported nearly twice as many adverse side effects as those taking the placebo.

The study has been published in the New England Journal of Medicine.

Sciatica is a commonly experienced condition that results in lower back pain that radiates from the nerves in the back to one or both legs. It is caused by irritation to, or damage of, the sciatic nerve, which runs from the spine all the way down to the feet. It is most common amongst those who are over 40 but can affect all ages.

According to Associate Professor Christine Lin from The George Institute for Global Health, the use of neuropathic pain medicines such as pregabalin for back pain and sciatica has increased by 535% over the past 10 years. “We have seen a huge rise in the amount of prescriptions being written each year for patients suffering from sciatica. It’s an incredibly painful and disabling condition so it’s no wonder people are desperate for relief and medicines such as pregabalin have been widely prescribed.

“But, until now there has been no high quality evidence to help patients and doctors know whether pregabalin works for treating sciatica. Our results have shown pregabalin treatment did not relieve pain, but did cause side effects such as dizziness.”

The research team at The George Institute, a medical research institute based in Australia, followed 209 patients with sciatica in Sydney who received pregabalin or a placebo capsule. After eight weeks there was no significant difference in pain intensity between the two groups, and over one year there was no significant difference in the amount of days lost from work.

Interestingly, almost two thirds of patients who took part in the study reported being very satisfied or satisfied with their drug regimen.

Lin commented: “Over the course of eight weeks the levels of pain that patients experienced did decrease but the drop in pain was the same for both those taking the drug and those on placebo. It seems people associate a drop in pain being due to taking a capsule, rather than something which would happen naturally over time.

“GPs who are prescribing pregabalin should take note of these findings, and talk with their patients about other ways of managing and preventing pain.

“Unfortunately there are no drugs proven to work for people with sciatica and even epidural injections only provide a small benefit in the short term. What we do know is that most people with sciatica do eventually recover with time. It’s also important to avoid bed rest and to stay as active as possible.”

http://www.georgeinstitute.org/media-releases/no-relief-in-sight-for-those-suffering-from-sciatica

http://www.nejm.org/doi/full/10.1056/NEJMoa1614292