Severe sciatic pain treatment refractory to treatment with Lyrica®, treated with palmitoylethanolamide, Normast®. Pain decreased totally within some days of treatment with sublingual micronized palmitoylethanolamide. The patient story: A medical doctor, former president of a big dutch hospital, suffered from severe neuropathic sciatic pain, pain score 10 minus over 10, without any response on treatment with pregabaline, apart from severe side effects such as confusion and dizziness, treated with palmitoylethanolamide, a body own fatty acid with analgesic properties. 

Palmitoylethanolamide (Normast®), is a body own fatty compound, related to anandamide and proven to have analgesic activity in neuropathic pain in many patients alysed in several clinical trials described on this site and in literature. ^[1][2][3][4] This is especially interesting, as recently it appeared that pregabalin was ineffective in the treatment of sciatic pain. ^[5]

Normast® is registered in European contries as medical food and so far in our clinic we did not see any side effects. This patient too responded well to the addition of Normast®to his treatment scedule. He could directly stop taking Lyrica. Normal dose of Normast® is twice daily 600 mg, starting with granules sublingual for 10 days, then 10 days twice daily 600 mg tablets and in case of early response, decrease dose to twice daily 300 mg, otherwise keep going with twice daily 600 mg Normast up to 6 weeks.

Sciatic pain or sciatica 

Lumbosacral radicular pain is characterized by a radiating pain in one or more lumbar or sacral dermatomes; it may or may not be accompanied by other radicular irritation symptoms and/or symptoms of decreased function.

The annual prevalence in the general population, described as low back pain with leg pain traveling below the knee, varied from 9.9% to 25%, which means that it is presumably the most commonly occurring form of neuropathic pain.

There is controversy concerning the effectiveness of conservative management (physical therapy, exercise) and pharmacological treatment. ^[6] 

The clinical diagnosis of sciatic pain or sciatica is referred to as a "radiculopathy", which simply means that a disc has protruded from its normal position in the vertebral column and is putting pressure on the radicular nerve (nerve root) in the lower back, which forms part of the sciatic nerve.Note that sciatica is not a medical diagnosis, but rather a symptom of an underlying problem in the lower back (such as a herniated disc or spinal stenosis that is compressing or irritating the nerve roots).

This is an important distinction because it is the underlying diagnosis (vs. the symptoms of sciatica) that often needs to be treated in order to relieve sciatic nerve pain. Sciatica occurs most frequently in people between 30 and 50 years of age. Often a particular event or injury does not cause sciatica, but rather the sciatic pain over time tends to develop as a result of general wear and tear on the structures of the lower spine. (see further on: http://www.spine-health.com/conditions/sciatica/what-you-need-know-about-sciatica) 

Jan M. Keppel Hesselink, MD, PhD, December 2010 

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