Which over-the-counter pain killer is the most effective for sciatica?

Doctor's Answer

Thank you for your question! Painkillers are very useful in the management of acute back pain that is limiting function and your ability to take part in normal day-to-day activities, but as the name implies, all that you are doing is settling the symptoms. The World Health Organisation has a “pain ladder”, with medicines that get stronger as you progress up it. It starts with simple medications such as paracetamol or anarex, before moving onto anti-inflammatories, and then the opiate-based medications.

In general, for acute pain, I tend to go high and then come down as soon as pain is settled, whereas for chronic pain, I suggest the opposite technique and use the weakest possible to control your symptoms.

If your pain is due to bones, paracetamol is a very good starting point, whereas if you have muscle spasm or inflammatory changes, anti-inflammatories are good. Used in combination, these can help with (neuropathic) nerve-type pain, but those that are more specific to neuropathic pain are usually prescribed by a physician. These include pregabalin, gabapentin and amitryptilline. These modulate nerve transmission to dampen down pain responses and hence alleviate your symptoms.

There are also alternative treatments that you can consider, including acupuncture, massage therapy and TENS. These can all help with back pain symptoms.

Nevertheless, if your pain is predominantly the type that radiates along your leg, I would suggest that you consider getting it assessed further (if you have not already done so) and consider further investigation if this is deemed necessary.

I hope this helps.

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