Question
Hi,

My question is basically what is a strong enough pain killer/anti inflammatory combination that will help long term with sciatica? I've been told arcoxia may help

About 6 months ago I went into A+E with back ache, (lower back through buttocks and down right leg) the pain was so severe I could neither sit down or get myself up from a laying position. I was diagnosed with sciatica, and given co-codamol and diclofenac as pain relief/anti inflammatory medication.. They worked for about 2 months taking the pain right down to just a niggle, but then it slowly increased again and I was switched to paramol (dihydrocodeine/paracetemol) for the pain. this again helped for a few months but recently the pain is starting to increase again..

Oh an mri scan didn't show up any damage the the lower spine so there's no surgery that's a viable option.

Other than that I'm a normally healthy 23 y/o guy from the U.K.

Peter

Answer
Peter,
Most of the medications you are describing are for mild pain. You must live in the UK, because I had to look all the names up. The one drug you mentioned did have codeine in it, but a small amount, and also had Tylenol. For sciatica that has become so severe that it interferes with your daily life you need more aggressive help and support. I would strongly recommend a chiropractor who specializes in this type of pain/injury. Or maybe even some physical therapy several times a week for a few weeks. Sciatica is when a nerve is being impinged and it does create quite severe discomfort and pain. It can be debilitating. That is why you need aggressive management. It is possible that a physician could put you on  a short term of steroids (very short term) to help with the inflammation. It appears that the anti-inflammatory drugs are not doing it for you, so be persistent. When talking to a doctor be sure to mention how you are otherwise a healthy, active 23-year-old, but this pain is interfering with your daily life. Sometimes you have to "speak their language" in order for them to really hear you. You really do want to get some xrays done, even CT scan and MRI for the purpose of ruling out any herniated disc or other abnormality. Most of the time sciatica is caused by an injury or a very narrow muscle in the buttock region (probably from birth). It is indeed painful, and you deserve to have the best care possible. You asked about medications, and they are different in the US. I have mentioned that you could be put on a short term of steroids, along with a stronger anti-inflammatory such as diclofenac, and as far as pain goes you could be given something at night such as hydrocodone. Certainly, if you have xrays done to rule out herniation of a disc or other functional abnormality they will know what they're dealing with. Sciatica is usually a symptom of another abnormality. With all this said, I hope you do have health coverage because the xrays I've mentioned are costly. If not, then seek out a free clinic (if you have them in your area) to at least get some pain relief. So, to summarize: The drugs you listed are not very strong. I'm unsure which drugs in the UK are equivalent to the ones I've mentioned. You need more aggressive management. And, I strongly encourage you to seek out a chiropractor. They are not as expensive as MDs and can usually help this type of pain very effectively. I hope I've helped a little, and feel free to email back if you need further advice.