Efficacy of Pregabalin in Patients With Radicular Pain

Although the efficacy of pregabalin has been demonstrated in several pain states and it is approved by the FDA for use in post herpetic neuralgia, diabetic neuropathy and fibromyalgia there are few studies of its efficacy in patients with radicular pain from herniated disc, spinal stenosis or failed back surgery syndrome. This study was conducted to evaluate the efficacy of pregabalin in these pain states.

Inclusion criteria

• Patients with pain in dermatomal distribution, in either cervical or lumbar region.
• History of pain for more than 3 months.
• History of herniated disc, spinal stenosis or failed back surgery.
• A series of epidural steroid injections within the past 6 months.
• Presence of motor or sensory neurological signs (hypoesthesia, hyperesthesia, allodynia, dysesthesia) in the affected dermatomes.
• Patients must be cognitively capable of completing the pain questionnaires.

Exclusion criteria

• Patients below 18 or over 65 years of age.
• Patients with mostly axial spinal pain.
• Presence of significant motor deficits, and /or bowel and/or bladder dysfunction.
• Workmen's compensation or disability issues.
• Patients with chronic depression and on depression medications.
• Addiction and/or substance abuse issues.
• Patients using gabapentin or failure to respond to previous gabapentin use.
• Patients with known peripheral neuropathy (e.g. DPN, PHN etc.).
• Known hypersensitivity to pregabalin use (hives, blisters, rash, dypnea and wheezing).
• History of angioedema with pregabalin use.
• Patients with known renal insufficiency, diabetes, congestive heart failure, cardiac conduction abnormalities, and/or thrombocytopenia.
• Patients using ACE-inhibitors and thiazolidinedione antidiabetic agents (Avandia®, Actos®).
• Pregnant patients.