[Efficacy of gabapentin in patients with discogenic lumbosacral radiculopathy]

Optimal conservative therapy of discogenic lumbosacral radiculopathy is a matter of debates. Contemporary guidelines recommend measures that predominantly have an influence on nociceptive mechanisms. However the mixed nature of pain in patients with discogenic radiculopathy requires approaches used for treatment of neuropathic pain. We carried out an open pilot study on efficacy of the anticonvulsant gabapentin in 25 patients with discogenic lumbosacral radiculopathy who were divided into two groups (with duration of pain episode 1 month or less and more than 1 month). Gabapentin was used in increasing doses up to 3600 mg/day. To the end of 8-week trial, the significant reduction of pain and restricted mobility was found. The reduction of symptoms was more rapid in the group with earlier onset of treatment. In both groups, the reduction of vertebral syndrome and neuropathic pain characteristics was noticed as well. The clinically significant effect was found in 59% of patients with early onset of treatment with gabapentin and in 51% of patients with later onset. These results suggest that early use of gabapentin (tebantin) holds promises for treatment of discogenic radiculopathy.