Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
The widespread use of NSAIDs, including aspirin, ibuprofen (introduced in the 1960s), and naproxen, marked a major advancement in managing pain from inflammation, a key component of sciatica.
NSAIDs inhibit cyclooxygenase enzymes (COX-1 and COX-2), reducing the production of prostaglandins that sensitize nerve endings and cause pain.
Muscle Relaxants and Anticonvulsants
In the mid-20th century, medications like muscle relaxants (e.g., cyclobenzaprine) were introduced to alleviate muscle spasms often accompanying nerve pain.
Anticonvulsant drugs such as gabapentin and pregabalin (approved late 20th century) emerged as effective treatments specifically for neuropathic pain by modulating nerve signal transmission.
Corticosteroid Injections
Starting in the mid-1900s, corticosteroids were used to reduce inflammation around irritated nerves. Epidural steroid injections became a common intervention to relieve sciatica caused by nerve root inflammation or compression.
Opioids and Controlled Use
Opioids continued to be used for severe pain, but increasing awareness of addiction risks led to more cautious prescribing and development of opioid alternatives shutdown123