If you have been struggling with low back pain for a while now, and have not found much in the way of relief, you might have started looking outside the box for some non-traditional ways to manage your pain. This search might have brought you to a medication called Gabapentin.
What Is Gabapentin?
What is gabapentin? Although it isn’t exactly a new medication (it has actually been available in the US since 1993), Gabapentin has rapidly been gaining popularity amongst many as a new pain reliever and as an alternative to opioids, specifically.
Gabapentin (also known by the brand name Neurontin) is a prescribed anti-seizure drug that is also prescribed for nerve pain. Gabapentin belongs to its own drug class, Gabapentinoids. It is an anticonvulsant that is most often used in the treatment of epilepsy, hot flashes, neuropathic pain, and restless legs syndrome.
How Does Gabapentin Work?
Gabapentin works by altering the electrical activity in your brain, which influences the activities of the neurotransmitters between your nerve cells. Basically this means that it changes the way your nerves send messages to your brain.
Sometimes your nerves can send false messages to your brain about pain that is supposedly happening in your body. For example, if something is pressing on a nerve in your spine, or a nerve isn’t working properly, that nerve might send your brain the message you have back pain, when there actually isn’t any.
By changing how your nerves work, gabapentin has the ability to reduce perceived pain.
How Does Gabapentin Help Low Back Pain?
Because of its effectiveness in treating nerve pain, gabapentin is gaining in popularity for the treatment of chronic nerve pain in the spine. This pain is often described as a shooting or burning pain, a sort of weakness or tingling throughout your back and neck.
This pain can also radiate through the arms and legs, like with sciatica. This is making it a popular consideration for those with back pain, especially for those who don’t know how or where their pain originally started.
My Doctor Prescribed Gabapentin For My Back Pain But I Don't Want To Gain Weight
Weight gain has long been established as a contributing factor to low back pain and as such, a good percentage of lower back pain patients struggle with maintaining a healthy weight. It is only natural, therefore, that taking a medication for back pain that could make your weight gain worse would be of great concern to those considering the treatment.
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How Worried About Gabapentin Weight Gain Should I Be?
While Gabapentin is a well-established medication with a good safety profile, there have been some reports that it may be associated with weight gain.
In 1997 one of the first trials to make the connection between weight gain and gabapentin was published in the journal, Therapeutic Drug Monitoring. The authors studied 44 patients that were being treated with gabapentin for seizure disorder.
They researchers found that most of the patients' weight increase started somewhere between the second and the third months of treatment and tended to stabilize somewhere between 6 to 9 months.
10 patients gained more than 10% of their initial body weight while 15% gained 5-10% of their initial body weight. That puts the percentage of patients who gained weight on gabapentin at almost 60%!
A 2015 study included gabapentin among their review of drugs commonly associated with weight change. Their research found that 'gabapentin was associated with a weight gain of 2.2 kg after 1.5 months of use'.
On the other hand, a 1995 study of 100 people taking gabapentin only found 2 people who had gained weight on the drug, but this study was looking at overall side effects and not specifically at weight gain.
How Common Is Weight Gain With Gabapentin?
While these studies suggest that there may be a connection between taking gabapentin and gaining weight it is important to note that weight gain is not a common side effect of gabapentin. Many patients don't gain weight at all when they are taking the medication and obviously there are some significant benefits to consider regarding the treatment.
It is worth considering that the weight gain that some patients experience could be due to other factors like other medications they might be taking at the same time to managing chronic conditions like depression.
They could also be experiencing an increase in appetite, or turning to comfort foods if their back pain is still bothering them. More research is needed to see the extent to which gabapentin affects weight gain in patients, and especially when it comes to treating low back pain.
How Effective Is Gabapentin At Managing Low Back Pain?
In terms of its effectiveness for low back pain, there is some evidence that gabapentin may be effective in treating this condition. A systematic review published in 2017 found that gabapentin was effective in reducing pain, improving function, and improving quality of life in patients with chronic low back pain.
Another study conducted in 2018 found that gabapentin was effective in reducing pain and improving function in patients with chronic low back pain who had not responded to other treatments.
Considerations
While these studies support the use of gabapentin for managing low back pain, it is important to know that more research is needed to confirm the effectiveness of gabapentin for low back pain. The studies mentioned above were relatively small and further large-scale trials are needed.
It is also important to note that gabapentin is not recommended as a first-line treatment for low back pain. International guidelines suggest that other treatments like physical therapy, exercise, and over-the-counter pain medications should be tried first.
Conclusions
In conclusion, while there is some evidence that gabapentin may be associated with weight gain in some patients, this is not a universally reported side effect.
Additionally, there is some evidence that gabapentin may be effective in treating low back pain, but more research is needed to confirm its effectiveness and it should not be used as first-line treatment.
If you are struggling to maintain a healthy weight already, your doctor may recommend you try other options like exercise, cognitive behavioral therapy, biofeedback therapy, or meditation instead. These treatments are first-line recommended treatment options, they often help patients to lose weight (not gain it) and they don't have any side effects to worry about.
As with any medication, it is important to discuss the potential risks and benefits of gabapentin with your healthcare provider before starting treatment.