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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31330
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have painful sciatica. I had an MRI and the orthopedic doctor

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I have painful sciatica. I had an MRI and the orthopedic doctor advised a pain shot first and then if that doesn't work, surgery.

I am in awful pain right and I won't get my pain shot for a few days. What's the best way to relieve this pain - walking around or resting in bed. It's hard for me to do anything at this point. I need some instant relief. Help??

Greetings Christel.

Bed rest or minimal activity would be advised. Following too would be recommended;

1) Back care in the activities of daily living, which is an integral component of the treatment of back problems. Back education is one of the most important thing which teaches the basic body mechanics, like correct posture for standing, standing at a desk or drawing board, sitting, brushing teeth, washing the face, pushing and pulling a weight, lifting a weight, getting in and out of bed, sleeping, getting into and sitting in a car. The training for these routine activity helps in preventing the spasm of the muscles. One needs to consult an occupational therapist or physical therapist which can educate about the proper and improper behaviors when back is painful in case they have to sit, bend forward, lie down, walk, cough, or sneeze. Following more need to be done:

a) Avoid activities which increases the pain.

b) Rest intermittently

c) Avoid bending at 90 degrees

d) Pushing and pulling should be avoided till pain subsides

f) Avoid prolonged sitting and standing

g) Avoid sitting or sleeping on floor

Following measures would help;

1) Ibuprofen
2) Back brace; lumbosacral corset
3) Deep electrotherapy; short wave diathermy, electrical stimulation
4) Acupuncture
5) Physical therapy.

Commonly used medications are;


1) amitriptyline (Elavil, Endep),

2) nortriptyline (Aventyl, Pamelor)

3) desipramine (Norpramin)

4) pregabalin (Lyrica)

5) phenytoin (Dilantin)

6) carbamazepine (Tegretol)

7) venlafaxine (Effexor)

8) duloxetine (Cymbalta)


For the local application; Capsaicin, an extract of chili peppers, when applied topically, has been demonstrated to relieve pain by affecting sensory fibers.


Other supplements and alternative integrative therapy protocols are;


1) Evening primrose oil

2) Acetyl-l-carnitine

3) Alpha-lipoic acid

4) Benfotiamine (Milgamma), 100 mg, is a lipid-soluble vitamin B1 analogue

5) Vitamin E

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.


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Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31330
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Dr. Arun Phophalia and other Health Specialists are ready to help you
I am going thru the exact same thing for the past 6 weeks. I already had 2 epidurals the needles in the back, it helped about 10%. If your mri shows the disc is herniated, they want to try non invasive measures first. I am tking codine for the pain but it dont help. Aleve which is generic naprosyn, over the counter they are 200mg. pills, if you take 3 every 8 hours, 600 mg is hospital strength. Its an antiinflammatory. It takes the edge off the pain. Bed rest, put a pillow between your knees when you lie in the bed and sleep in a fetal position so that your knees are bent up Put an ice bag where the pain is, ice helps. The pillow and bent in a fetal position helps take the pressure off the sciatica nerve. If you get no relief then surgery. But mds want to give you the best shot at these measures first. Its been 6 weeks for me, but I probably need the surgery. Some say it can take months to get better, if it does but if the pain is radiating to your back of legs straight down, and the pain is excruciating, and the injections of steroids dont help, they its surgery . Best of luck, but the ice does help. I lay on it at least 4-5 times a day a half hour to an hour at a time