Most drugs have little effect on back pain or back pain with sciatica. Surprisingly, a combination of Buprenophine and Pregabalin did seem to make a difference in milder back pain cases.
Disappointingly, drug work little in back pain/sciatica pains:
Mathieson, Stephanie, et al. “Combination drug therapy for the management of low back pain and sciatica: systematic review and meta-analysis.” The Journal of Pain 20.1 (2019): 1-15.
https://www.sciencedirect.com/science/article/abs/pii/S1526590018303195
“There is no clear evidence to support any combination drug therapy for the management of low back pain”
“Most combinations had no or small effect on pain and disability”
Even cymbalta had little impact:
Surprisingly, a combination of Buprenophine and Pregabalin did seem to make a difference in milder(pain 3-3.5/10) back pain cases.
Pota, Vincenzo, et al.
Combination therapy with transdermal buprenorphine and pregabalin for chronic low back pain.
Pain management 2.1 (2012): 23-31.
https://pubmed.ncbi.nlm.nih.gov/24654615/
Comment – butrans patches have strong antidepressant effects:
Using the Pain System to Treat Depression – Buprenorphine
http://painmuse.org/?p=6720
It may have little addiction potential as it has a ceiling effect of efficacy (no increased benefit beyond a certain dose). By itself, it seemed to have little effect on pain but with pregabalin worked. Not sanguine it would work in severer pains but would be safer than straight opioids