A Case of Sciatica with marked Improvement following Antidepressant Medications.

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A 40-year-old man had been troubled by low back pain for over a year. Lumbar traction, "hot packs", analgesic drugs and a local anaesthetic injection had all been ineffective.His low back pain and right sciatica became severe in September 1993, and he was admitted to the Department of Orthopedic Surgery at St. Mary's Hospital for investigation in November 1993.X-ray examinations, myelograms and MRI of the lumbar region revealed no particular findings to indicate the need for surgery. Subsequent conservative therapy, including epidural blocks were not effective, and he was eventually referred to our rehabilitation hospital at the end of December 1993.On admission, he limped and had severe symptomatic scoliosis. However at times he appeared to gain relief from symptoms and to have obsessive idea.He was therefore referred for a psychologic assessment and diagnosed as having masked depression.50mg of the antidepressant, "clomipramine" in two half doses, was administered in the morning and evening.He responded very well to the drug, and the complaints of pain almost stopped after one month of treatment.
西日本整形・災害外科学会の論文