A common sciatica drug has been found to be no more effective than a placebo, according to a study published in the New England Journal of Medicine.
The study also found that people taking the drug pregabalin reported nearly twice as many adverse side effects as those receiving the placebo.
Sciatica (which is characterised by pain, tingling or numbness along the sciatic nerve) is estimated to affect about one in 100 people. Since its introduction in 2004, pregabalin – also known by its brand name Lyrica – has become the most widely prescribed medicine for the condition.
The researchers began their investigation having become increasingly concerned by the rise in the use of the drug, coupled with limited data on its effectiveness and fears over the drug’s safety. One of the possible serious side effects is suicidal thoughts or actions.
They followed 209 people with sciatica over the course of a year. After eight weeks there was no significant difference in pain intensity between the group taking pregabalin and those receiving the placebo. Over one year there was no significant difference in the amount of days lost from work.
Christine Lin, the study’s lead author, said: ‘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.
‘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.’
This is a good, solid study; a randomised, double-blind, placebo-controlled trial. It is important to point out, though, that the study is focussed specifically on the efficacy of pregabalin in treating sciatica, not its efficacy in treating other conditions like anxiety, or neuropathic pain as a whole.
Research score: 5/5