Patient description: The patient is a 34-year-old African American man with the known history of Sickle cell disease comes to the clinic with severe bone pain. The patient had severe pain in his lower back that radiated to both thighs scored 9 out of 10. The patient has had positive history of sickle cell crises since childhood. He also had the same symptoms in past two weeks treated with oxycodone which was not beneficial to his pain. His PCP sent him to the emergency department to receive intra venous pain modulators. The patient is afebrile within the normal blood pressure. No splenomegaly was detected in the physical exam. He has no positive history of drug allergy. He won't smoke or uses any illicit drugs. The lab study is as bellow: Hgb: 8 g/dl WBC: 10000 /mm3 Plt: 300000 /ml MCV: 106 fL Hemoglobine electrophoresis: 91% HbS 6%HbF 3%HbA2 AST: 22 U/L ALT: 43 U/L Alk P: 53 U/L Ferritin: 1200 ng/ml

Clinical trial eligibility criteria: eligible ages (years): 19.0-999.0,  Radiculopathy Sciatica In this study chronic lumbar radicular signs and symptoms are defined as pain located in the lower lumbar spine corresponding to L1 and below for at least 3 months with radicular characteristics, i.e. pain described as sharp, burning, with numbness and/or tingling. Ability to understand the study measures and mentally capable of give consent to participate in the study (based on an 8th grade education level) Willingness to refrain from taking opioids other than their study medication. Patients with failed back syndrome who satisfy the outlined in Appendix II. Patients with a pain level of 4/10 or greater on a scale of 0 to 10  Major coexisting medical condition such as cancer, chronic obstructive pulmonary disease and severe hepatic and renal dysfunction. Prostatic disease requiring usage of urological medications. Pregnancy or lactation. Unwillingness to discontinue pain medication(s) at study onset as follows: narcotic pain medications, tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs). Presence of pain of greater intensity in any other location than the low back or leg. Current major depression requiring usage of antidepressants. History of narcotic abuse at any time in the past and/or drug or alcohol abuse in the past year. History of narrow angle glaucoma. History of epilepsy. Current symptoms of coronary artery disease. History of fibromyalgia as described by Wolfe F et al., (1990) (a minimum of 12 out of 19 points of tenderness must be present to satisfy for fibromyalgia). History of spinal unstability (based on an MRI finding of grade II spondylolisthesis or greater). Cognitive impairment such that the individual is unable to give informed consent, complete study data collection tools or required study visits. Unwillingness to use adequate contraception (such as birth control pills or barrier methods with spermicide simultaneously). Presence of other medical condition presenting with numbness and pain in lower extremities, such as diabetic polyneuropathy and peripheral vascular disease. Allergy to any of the medications used in the study. Age 18 years or less due to rarity of sciatica in this age group