Key takeaways
- For severe or chronic sciatic nerve pain, doctors may prescribe medications like anticonvulsants, corticosteroids, opioids, or muscle relaxers.
- Over-the-counter pain relievers may help with mild sciatic nerve pain, but prescription medications are often more effective for nerve pain because they target the source of the pain signals.
- In addition to medications, natural remedies like hot and cold packs, stretching, and physical therapy can also help to alleviate sciatic nerve pain and prevent future occurrences.
Overview
Nerve pain, also known as neuropathic pain or neuralgia, can occur in any nerve in your body, including your sciatic nerve. The sciatic nerve stretches from your lower back down to your heels. It is the largest nerve in the human body.
Nerve pain occurs when a health condition or an injury causes the nerves to send a pain message to your brain.
Nerve pain often feels like a sudden shooting or stabbing sensation, similar to an electric shock, but it may also cause tingling or a burning feeling. Neuropathic pain can be particularly severe and debilitating, and it may sometimes worsen at night, making it difficult to rest.
Depending on how severe your sciatic nerve pain is, doctors may recommend various medications. These can range from over-the-counter (OTC) drugs that may help ease mild nerve pain to stronger prescription medications to provide relief from severe and persistent pain.
Need a diagnosis or prescription quickly? Optum Perks offers personalized on-demand care in as little as 15 minutes. For $29, answer a few questions online and receive a diagnosis and treatment plan from a US-licensed healthcare professional. Get started here.
Can sciatica be permanently cured?
It is possible for sciatic nerve pain to be cured completely. In fact, most cases of sciatica go away within 6 weeks, even without medical intervention. This is because many cases of sciatica are caused by underlying factors, such as a herniated disc, that the body can heal from.
Many doctors seek to treat sciatica conservatively, with as little medical intervention as possible. However, some cases of sciatic nerve pain become chronic (long-term) and need more detailed treatment plans.
Prescription treatments for sciatica
Doctors typically prescribe medications to treat severe and chronic cases of sciatic nerve pain, also known as sciatica. Medications they may recommend include:
- anticonvulsants
- corticosteroids
- opioids
- muscle relaxers
Anticonvulsants
Anticonvulsants are medications people often take to manage seizure disorders, but they are also effective in treating neuralgia. This is because these drugs change the way ion channels work and how pain messages go in and out of the cells.
Anticonvulsants for nerve pain may include gabapentin (Neurontin), levetiracetam (Keppra), and pregabalin (Lyrica). When you take anticonvulsants, you may develop some side effects, such as:
If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.
Free prescription coupons
Seriously … free. Explore prices that beat the competition 70% of the time.
Get free cardSteroid medications
Doctors may prescribe injectable or oral corticosteroids if you do not experience any pain relief after taking OTC treatments like nonsteroidal anti-inflammatory drugs (NSAIDs). The primary benefit of corticosteroids lies in their ability to reduce inflammation.
Some 2020 research suggests that corticosteroid injections may be effective for sciatica, although the improvements may be short-term. Similarly, some 2023 research finds that oral steroids may have some effectiveness for sciatica despite an increased risk of mild adverse effects.
The side effects associated with corticosteroids include:
- gastrointestinal problems
- increased appetite and weight gain
- insomnia
- increased chance of infections
- high blood sugar
- high blood pressure
- eye conditions, such as glaucoma
- mood changes
- depression
Examples of steroid medications include:
- prednisone (Prednisone Intensol)
- prednisolone (Orapred ODT)
- dexamethasone
Opioids
Opioid drugs make changes to how the calcium and potassium ion channels work, providing relief from neuropathic pain.
Opioids are usually very effective for sciatica, but doctors usually prescribe them only as a second-line treatment option if anticonvulsants and other medications do not provide pain relief or are not suitable for you.
This is because opioids can have several severe side effects, and they may lead to addiction or dependence. If doctors prescribe you opioids, you should strictly follow their guidance about when and how much opioids you have to take. The side effects of opioid medications may include:
- dizziness
- nausea and vomiting
- seizures
- constipation
- lethargy
- breathing difficulties
Opioids for nerve pain may include:
If you experience any severe side effects or have difficulties breathing after taking an opioid medication, contact a doctor immediately.
Muscle relaxers
Muscle relaxers like cyclobenzaprine (Amrix) and tizanidine (Zanaflex) may relieve pain in people with sciatica. However, these drugs may not provide immediate pain relief, so it may take a couple of days or weeks before your discomfort improves.
These medications prevent your nerves from sending pain messages to your brain. Muscle relaxers do not typically cause serious side effects. However, you may experience milder side effects such as drowsiness and nausea.
OTC options
If you experience some mild sciatica pain, doctors may recommend you start with OTC medications to manage your discomfort before prescribing stronger drugs. Oral NSAIDs, such as ibuprofen (Advil), or other painkillers like acetaminophen (Tylenol), may help with sciatica pain.
However, research has found that NSAIDs may not be very effective in treating nerve pain. Some 2024 research looked at naproxen (Aleve) only showed very small, possibly insignificant benefits compared to the placebo. Stronger pain medications are usually needed.
This is because OTC medications do not usually act on the root cause of nerve pain, and they do not change how nerves send pain signals to your brain.
Still, OTC medications may help you if your pain is mild or if you have not had the chance of seeing a doctor yet.
Natural remedies for sciatic nerve pain
Several natural remedies may improve your sciatic nerve pain and may help prevent it from coming back. Natural remedies may be used in combination with pain medications. These may include:
- applying ice packs or hot pads to the area where you experience discomfort to reduce inflammation
- performing lumbar spine and hamstring stretching exercises
- performing exercises to strengthen your core
- doing gentle physical exercise, such as swimming, walking, or aquatherapy
- maintaining a good upright posture
- trying a deep tissue massage
- avoiding lying in bed for very long periods
- avoiding sitting or standing still for too long, as this can put pressure on your lower back and cause irritation to the sciatic nerve
- using proper lifting techniques when performing daily activities
A physiotherapist can recommend the most appropriate exercise and stretching plan to help improve your sciatica pain and reduce the chance of it coming back.
Summary
Sciatic nerve pain can feel like a burning sensation or a stabbing pain in your buttocks and down to your leg. Sciatica pain can be severe, and it may make it difficult for you to rest and perform your daily activities. Several medications can help improve sciatic nerve pain.
While OTC medications are not usually very effective, and they typically only help in the case of mild sciatic nerve pain, several prescription drugs are very effective for sciatica. This may include anticonvulsants, corticosteroids, opioids, and muscle relaxers.
Hot and cold packs, stretching, and gentle physical exercise may also help improve sciatic nerve pain. A physiotherapist can recommend the most appropriate exercise plan based on how severe your sciatic nerve pain is.
Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.