Sciatic pain is often caused by a lumbar herniated disc, degenerative disc disease or spinal stenosis. Typically, pain starts in the buttocks and runs down the back of the leg to the foot. It is often treated with medications (anti-inflammatory drugs, muscle relaxants, opioids, tricyclic antidepressants, or antiepileptic drugs), physical therapy, steroid injections and surgery. Herein we report a case of severe recurrent right sciatic pain in a 71-year-old man referred to our pain clinic The patient presented persistent pain (numeric rating scale 8/10) originating from the lower back running down into the right thigh and intermittent claudication. His otolaryngologist had prescribed him 20mg oxycodone per day. MRI of the lumbar spine revealed a grade 1 spondylolisthesis at L5-S1, degenerative disc disease at L5-S1 and herniated discs at L3-4, L4-5 and L5-S1. The patient received one caudal epidural steroid injection and was prescribed 10mg oxycodone per day. The patient’s pain intensity and life quality improved greatly during a 9 month follow- up period. Physicians may want to consider multimodal analgesia instead of opioids to resolve chronic sciatic pain in patients unwilling or unable to receive surgery.

sciatic pain, multimodal analgesia, epidural steroid injection, opioids.