DEAR DR. GOTT:
I am a 76-year-old man having a difficult problem with sciatic nerve pain.
I have had episodes of this ailment before but never to this degree. The pain is almost daily — sometimes worse than others. I have had X-rays, 16 chiropractic visits and have visited my internist.
The chiropractic adjustments seemed to make some progress but they would only last a few days and then the pain would get worse. I discontinued these visits.
My doctor told me that time would help and gave me a prescription for ibuprofen. I regularly use ice packs which seem to relieve the discomfort to some degree.
I am active and walk every morning. I eat a healthful diet with little caffeine intake and have no major health problems. I have tried limiting my activities but it didn’t help. I even bought a riding lawnmower thinking it would help but it only makes the pain worse.
DEAR READER:
Sciatica is a fairly straightforward condition in which part of the spine pushes on the sciatic nerve. This nerve is located near the base of the spine and can cause low back pain and numbness, tingling and pain in the buttocks and/or legs. Some experience these sensations in one or both legs (hips to ankles or toes) or in one or both thighs.
Testing can include X-rays but MRIs are more detailed and can show soft tissue swelling that may be the culprit. Treatment often consists of stretching, rest, hot or cold packs and anti-inflammatory drugs such as ibuprofen. For more severe cases, narcotic pain relievers may be prescribed or epidural injections can be given.
You appear to have had appropriate care but your symptoms are worsening. At this point I recommend you be examined by an orthopedic back specialist who can order more advanced testing to determine the cause of your pain. He or she can then recommend appropriate treatment options. If this fails to help, the next step would be to be seen by a pain specialist or clinic. In this instance, the goal is to help you manage your pain levels, often with the use of alternative treatments such as massage therapy, physical therapy, acupressure or acupuncture and medication if needed. Some clinics even promote water aerobics because it provides resistance and is low-impact.
You have been suffering with this for too long and need additional testing in order to get an accurate diagnosis. It is also time to consider more powerful medication or alternative forms of treatment since your modest efforts don’t appear to be working. Speak to your doctor and ask for the appropriate referrals to more specialized physicians and/or clinics.
To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
About Dr. Gott