High versus low dose Nortriptyline for pain control and sleep in the presence of radicular back pain.

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Our aim is to evaluate if a higher dose of drug called Nortriptyline improves sleep and pain control in patients suffering from leg pain due to an underlying spinal pathology. The information obtained will improve our management of future patients with your condition. We are performing this study throughout the Wellington area. We will assess in clinic in the same manner we would do normally, and initiate the same management we routinely give. However, in addition we will ask some medical questions to ensure it is safe to take the drug and that the back problem is suitable to be included in the study. Then we will randomly allocate to a low or high dose of the drug Nortriptyline. This drug has traditionally been used in a low dose for this back problem but some doctors prescribe higher doses. In these higher doses it is not known if the pain control is improved nor is it known if with this treatment sleep disturbance is minimized. The medication is reasonably safe as long as you do not have a history of: cardiovascular disease, prostatic hypertrophy, chronic constipation, glaucoma or elderly. The medication has the potential, like many other medications, of producing side effects. These include: dry mouth, sedation, constipation, and increased appetite. An occasional side effect is a rapid or irregular heartbeat.

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