IGX

My wife has developed consistent paint that runs from moderate to severe along the posterior portion of her upper leg and lower hip. She saw her GP today who diagnosed sciatica and prescribed physical therapy and a 60 day supply of 300 mg. of Gabapentin twice a day.

This Gabapentin stuff sounds like a weird drug that's used for a lot of things - none of which are Gabapentin.

Any thoughts from those in the know about sciatica and this drug?

Don't know about the drug, but yoga and some of Furman's stretches (especially the one where I sit in a chair, put my R foot over the L knee, and put slow steady pressure on the R knee and vice versa) really helped my sciatica.

gabapentin has shown efficacy in chronic pain. short half-life (about 2-5 hours) so it's normal to take more than once a day, however i can't speak for the dose. I agree your wife should try movement to help with what is causing the pain.

If nothing works and it comes to surgery, let me know. I can tell you how mine went and the upshot.

Don't know about the drug, but yoga and some of Furman's stretches (especially the one where I sit in a chair, put my R foot over the L knee, and put slow steady pressure on the R knee and vice versa) really helped my sciatica.

THIS ^^^^

Stretch. Glutes, hip flexors, calves multiple times per day. Stretch hamstrings, quads, groin once a day. Walk, as much as possible. That's the best starting point. Muscle relaxers and Motrin take the edge off. A Xanax will help as well if it's mentally starting to beat her down. Once the pain is under control I'm a huge advocate for sled dragging. Not the stupid shit though, just forward walking, backward walking, and lateral walking. If she's able, do some planks a few times per week. I've delt with this for 10 years or more and this is finally what has started to fix me. Kettlebells, deadlifts, etc didn't work for me and made shit worse. People with sciatica normally have issues with bending and the waist, good form or bad it hurts either way. Thats just my experience.

She needs to do Foundation Training. Book I believe is on Kindle. Do the whole program as laid out. It's very well thought out and I've shared it with members on here.

Foundation Training is excellent and stretching the hips, especially the piriformis. The sciatic nerve runs right next to, and in some people through, the piriformis muscle. Now if the impingement is at the spine, the piriformis stretches might not do much, but its worth a shot. The stretch Turd describes is a piriformis stretch.

The evidence for gabapentin for nerve based pain is less than robust, and any time you are mucking about with neurotransmitters you run the risk of weird and unpleasant side effects. My thoughts would be piriformis stretching as above, gabapentin if absolutely needed until the stretches kick in, NSAID of choice (mine is naproxen) routinely for a week (not 'as needed') to get the anti-inflammatory action going, then drop back to as needed.

Thanks much, this is very useful. We'll get on the exercises recommended and skip the gabapentin.

If this is a newly developed pain, not a chronic one, it is likely to go away within one to six months. I am a bit surprised at gabapentin given as the first choice, and would stick to simple analgesics: acetaminophen, NSAIDs and codeine, unless contraindicated. Movement, stretching, yoga are always good and have low risk, just have to be done carefully. Red flags - change in the character of pain and muscle weakness, which would warrant more detailed work up.