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Cited by 47Musculoskeletal pain and rehabilitationSpine and Intervertebral Disc PathologyPain Mechanisms and Treatments

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Which pain medications are effective for sciatica (radicular leg pain)?

Pinto, Rafael Zambelli, Verwoerd, Annemieke J. H., Koes,, Bart W.·2017·BMJ
DOI 10.1136/bmj.j4248
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Abstract

#### What you need to know Sciatica is commonly seen in primary care. Its prevalence in the general population varies between 3% and 14%, depending on the definition used.1 The prognosis of acute sciatica is generally favourable: data from a prospective study of 183 patients with a median disease duration of 16 days show that in approximately one third of patients, symptoms improve greatly (ie, measured on a 4 point scale, 1=worsened, 2=remained unchanged, 3=improved, and 4=improved greatly) within two weeks, and about three quarters of patients reported any improvement within 12 weeks.2 Nevertheless, in another study of 172 patients, 30% continued to report persistent and disabling symptoms after one year.3 Sciatica is a symptom rather than a specific diagnosis4 and is used broadly to refer to pain that radiates along the path of the sciatic nerve.5 The commonest cause of sciatica is impingement of lumbosacral nerve roots, as they emerge from the spinal canal, by a herniated intervertebral disc (fig 1). Other causes of impingement include spondylolisthesis and spinal tumours or cysts.4 For this reason, symptoms of sciatica often co-exist with low back pain, but disturbances along the course of the sciatic nerve can also arise from locations other than the lower back (ie, due to piriformis syndrome, diabetic radiculopathy, and hip fracture or dislocation).5 Fig 1 Common causes of sciatica. Disc herniation is the commonest cause. Spondylolisthesis can cause impingement Patients with sciatica …

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  • Commonly prescribed analgesics (NSAIDs, opioids, corticosteroids) are frequently associated with adverse events such as nausea, vomiting, and palpitations, which often compromise treatment adherence.

    “Commonly prescribed analgesics— including nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and corticosteroids—are frequently associated with adverse events such as nausea, vomiting, and palpitations, which often compromise treatment adherence.7”

    From Acupuncture Therapy for Sciatica: An Overview of Systematic Reviews and Meta-Analysis (2025) · cites this paper as [7]

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Metadata

Authors
Pinto, R. Z., Verwoerd, A. J. H., & Koes
Affiliations
  • Universidade Federal de Minas Gerais (BR)
  • Erasmus MC (NL)
ORCID
Venue
BMJ
Publisher
BMJ
Published
2017-10-12
Volume
359
Pages
j4248
ISSN
  • 1756-1833 (ISSN-L)
  • 0959-8138
DOI
10.1136/bmj.j4248
OpenAlex
W2761697832
Cited by
47
References
0
Citations by year
2026: 2 · 2025: 4 · 2024: 7 · 2023: 9 · 2022: 3 · 2021: 7 · 2020: 10 · 2019: 4 · 2018: 1
FWCI
2.86
Type
journal article
Language
en
Open access
closed
Licence
www.bmj.org/licenses/tdm/1.0/terms-and-conditions.html (tdm)
Locations
  • BMJ (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • UNESP Institutional Repository (São Paulo State University) (submittedVersion)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Spine and Intervertebral Disc Pathology
  • Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Keywords
sciatica, radicular leg pain, analgesics, analgesic efficacy, disc herniation, spondylolisthesis, piriformis syndrome, low back pain, primary care
MeSH terms
Clinical Decision-Making, Acetaminophen, Analgesics, Opioid, Anti-Inflammatory Agents, Non-Steroidal, Anticonvulsants, Antidepressive Agents, Benzodiazepines, Biological Products, Diagnosis, Differential, Glucocorticoids, Humans, Sciatica, Randomized Controlled Trials as Topic, Low Back Pain, Evidence-Based Medicine

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