Sciatica Just One Cause Of Back Pain

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DEAR DR. DONOHUE: Our basement flooded, and I was chosen to clean it. All that pushing, lifting and scrubbing did a number on my back. It’s been bothering me for two weeks. I never had a back problem before, but my dad used to have them all the time. He said it was sciatica. I believe that’s what I have. How can I get rid of it? — M.J.

ANSWER: Don’t jump to conclusions. Sciatica (sigh-AT-ik-ah) is only one cause of back pain. The fact that your father had it has little bearing on your having it. Did your dad arrive at the diagnosis on his own? Many people do. Quite often, they’re wrong.

The sciatic nerve is a large nerve formed by the intermingling of nerve roots coming from the lower segments of the spinal cord. It and its branches run from the lower back through the buttock and down the leg to the ankle and foot. Pressure on the nerve at any point in its course irritates it and produces the pain of sciatica. The most common cause comes from a protrusion of one of the back’s disks, which presses on the spinal cord rootlets that combine to build the nerve.

Low-back, buttock and leg pain are the hallmarks of sciatica. The leg pain is on the back of the leg or its outer side.

Even though the diagnosis is a bit iffy here, sciatica — and most of the other causes of low-back pain — get better in three to six weeks. You don’t have to completely rest. Strict bed rest is contraindicated. Walk around and perform the normal activities of daily life, but don’t lift, push or perform manual labor. Use heat or cold on your back, whichever you find benefits you more.

Tylenol (acetaminophen) usually controls pain. If it doesn’t, one of the nonsteroidal anti-inflammatory drugs (Aleve, Advil, Motrin) can be tried. An injection of steroids into the back takes care of inflammation that adds to the pressure on the nerve. Surgery usually isn’t necessary. The long-term outlook is good.

If the pain hasn’t gone by four weeks, see a doctor. See the doctor promptly if pain increases or you lose control of your bladder or bowels.

The booklet on back pain provides more information on this common problem. To obtain a copy, write: Dr. Donohue — No. 303W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I remember your once writing about how a person with COPD ought to breathe. My dad was just diagnosed with COPD, and I would like to pass that information to him. Will you please repeat it? — S.A.

ANSWER: That is pursed-lip breathing. The person puckers the lips as though going to whistle or give a kiss. Then he inhales through his nose and exhales through the pursed lips. Exhaling should be more prolonged than inhaling. This technique keeps the airways opened to allow more air to get into the lungs and more carbon dioxide to get out of them.

“COPD” stands for “chronic obstructive pulmonary disease”: emphysema and chronic bronchitis.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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