DEAR READER: Burning, stinging, pain, pins and needles, and other abnormal sensations of the buttocks and thighs are often the result of a spinal problem, most commonly sciatica. This condition is caused by impingement of the sciatic nerve in the lower back, usually caused by a slipped, ripped, torn or otherwise displaced disc. Other symptoms include low back pain, abnormal sensations in the low back, calves or feet, and urinary or fecal incontinence. I suggest you speak with your physician about this possibility and get an X-ray or MRI of the thoracic (middle) and lumbar (lower) areas of your spine.

To provide 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 No. 10 envelope and a $2 check or money order made payable to Newsletter and sent to P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Over the next few months, they would come back occasionally in my face and head for up to a week, only to disappear again. I would describe the feeling as electrical currents running though my face and head and numbness in my nose and lips.

I went to see my primary care physician who sent me to a neurologist. He checked my reflexes, examined my gait and sent me home. Several weeks later, I went to a different neurologist who ordered X-rays and an MRI of my head and neck. Because of some disc misalignment I was given exercises to do. This helped but I continued to have problems, now in my lower back, down into my buttocks and legs.

My sleep is affected because I have muscle spasms that run from my back, around to my stomach, and down both legs into my feet. When I wake up I feel as though I have run a marathon. It used to only be occasionally but now it seems like it happens every night and has progressed to the point where I requested a prescription sleep aid because I couldn’t sleep at all. I don’t like taking medication but not sleeping is worse than taking too many pills.

I was referred for physical therapy but quit after three weeks because there was no significant change in my situation. Now I am frustrated and depressed because no one can tell me what is causing these symptoms and how to make them stop.

I am currently waiting to see the neurologist again. He ordered X-rays of my thoracic and lumbar spine which showed normal but not significant degeneration, mild to moderate spurring and mild scoliosis. I assume the next step will be to have an MRI of these areas.

I don’t know what else to do. The pain is not extreme or debilitating but when the muscle spasms start, sleeping, standing and walking become challenging, if not impossible. My coordination is also suffering because my leg muscles have become so stressed.

DEAR READER:
Your symptoms suggest to me that you have a pinched, compressed or damaged nerve somewhere in your back. Given the numbness, tingling and spasms are confined to your lower back, buttocks and legs, I would venture to guess the problem lies somewhere near your sciatic nerve.

Sciatica usually affects only one leg but on occasion can affect both. Your X-rays have shown only mild degenerative changes but this does not mean serious damage isn’t occurring because of them. If a disc slips a fraction of a millimeter in the wrong direction, it can create tremendous pain and debilitating symptoms.

I understand this is a difficult situation but I urge you to follow your neurologist’s advice. In the meantime I recommend you try low-impact exercise and stretching in an attempt to strengthen your back muscles. Stronger muscles can hold the discs and vertebrae in a better alignment. Perhaps chiropractic manipulation, acupressure or acupuncture might help.

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.

When I first developed the pain I was incredibly busy. I was taking care of my husband who was dying of lung cancer and working with kindergarteners and first graders. I also had to take care of the housework, laundry, grocery shopping, getting my husband to and from all his doctor appointments as well as myself for my back pain.

I had been referred to several doctors and none could offer me a diagnosis. I finally went to a chiropractor who ordered X-rays and diagnosed me with sciatica. Adjustments gave me temporary relief. I was considering acupuncture as a next step because I was desperate to find a solution, when I happened upon an article in my paper. It was written by a physician (not you) who gave an exercise used to reduce sciatic pain.

After reading the article, I tried the exercise. I started feeling a little better within a few days and I was pain free after two months. I continued to do it several times a day for three or four years. When I was sure I was going to be okay I stopped. The exercise really works. I have been pain free for 25 years now. I only use it now when I start to feel the slightest twinge of back pain. I do it as often throughout the day as I can for several days just to make sure I won’t have a problem.

I hope you print my letter because I know it will help others. Here are the instructions as I read them 25 years ago.

Lay flat on your back on a firm surface. Stretch both arms above your head and stretch your legs down as far as they will go. Next, with one leg at a time, stretch your heel down and point your toes backward toward your knee. Hold for a count of five then relax. Repeat with the other leg.

You will feel your spine stretch. This can be done once with each leg and a few times with each leg before getting back up to go on with the day. It in important to do the exercise throughout the day whenever you have a chance because it takes time to stretch the muscles and put them back in place.

DEAR READER:
I am passing your letter on to my readers in the hopes that this will help some of them. Sciatica and back pain in general can be very troublesome and difficult to treat. This is primarily because we use our backs much more often than we realize and unfortunately, most do not use proper precautions when exercising, weight lifting or carrying heavy objects. This can lead to muscle sprain or strain and can also cause the spinal discs to slip out of place and put pressure on the spinal nerves. If not properly treated, this constant nerve pressure can be disabling.

I am now 68 years old and lead a very active life.

DEAR READER:
Thank you for your recommendation. The pain of sciatica is difficult for anyone to face. You were fortunate to find an alternative that worked so well. I’ll pass the information on in the hope it will inspire others.

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.

When I am standing in line, taking my ½ mile daily walk or just about anything that involves standing for more than a few minutes, I get a tingling sensation at the bottom of my spinal cord (in the buttocks area). As soon as I feel this I know I need to find someplace immediately to sit down. If I don’t, the sensation goes all the way down to my toes. If I try to walk it feels as thought I am on marbles and I never know if my next step will hold me or if I will fall. This has been happening for several years.

I never know when it will happen because it doesn’t happen all the time. The only thing that stops the tingling and numbness is to sit down for a few minutes. I have had an X-ray of my spine and was told I have arthritis but that it should not cause the symptoms I am experiencing.

I don’t know where to go now or what to do to make this go away. I do not take any medication on a regular basis. Please help!

DEAR READER:
Your symptoms are suggestive of sciatica. This is a relatively common condition of the spine caused by compression of the sciatic nerve that leads to numbness, tingling, burning, a pins-and-needles sensation and other symptoms in the lower back, buttocks and/or legs. Sciatica commonly affects only one leg, but in some people it can affect both legs (sometimes equally).

I recommend you see an orthopedist who specializes in the spine. He or she can examine and test you to determine the cause of your symptoms. You may need magnetic resonance imaging (MRI). This test is more detailed and can show soft tissues such as vertebral discs and muscles. In most instances back pain is caused by a herniated, bulging or torn disc that allows the vertebrae to touch or compress surrounding tissue and nerves.

If it is sciatica, simple exercises, chiropractic manipulation or physical therapy may be all that is needed. Because your symptoms only occur occasionally they suggest the degree of compression is minimal. However, if your symptoms progress, worsen or become constant you may require more aggressive therapy such as epidural steroid injections or anti-inflammatory or pain medications. For severe cases that do not respond to other therapies, surgery may be a last resort option for certain individuals.

Another cause of your discomfort may be muscle spasm but in your case this appears to be unlikely because of the extent of the tingling sensation. Muscle spasm is often contained to a single area.

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.

Can you tell me anything about these treatments? Have any of your readers found help with them?

DEAR READER:
There are numerous therapy methods available that are based on body movement. Some of the more common ones include Tai Chi, yoga and the Alexander Technique. The latter therapy uses a combination of verbal instructions and light touch, focusing on alignment of the spine, primarily between the head and neck. It is commonly used on people with postural problems.

Prolotherapy therapy involves injecting a sugar solution into painful tendons and ligaments. The normal course takes between six and 10 sessions, sometimes requiring multiple injections during those sessions. Any pain experienced is mild and temporary. The procedure is intended to stimulate the production of connective tissue, but studies report conflicting evidence for effectiveness in treating chronic back pain unless the injections are combined with a program of exercise and spinal manipulation.

From all reports, more research is necessary to determine if prolotherapy is successful in the treatment of chronic, low back pain.

Feldenkrais involves a series of exercises through simple pain-free movements. The two-part series involves lessons in movement provided by a teacher in group sessions and individual hands-on sessions guided by a practitioner.

Recent studies indicate the practice may be useful for neck and shoulder pain and anxiety. Since your complaint is sciatica and low back pain, this choice might not be the most appropriate one for you.

I feel both non-surgical alternatives you have suggested would not be in your best interest and would prefer you take a different course of action. Initially, make an appointment with your primary care physician. Explain that you prefer not to become involved with drugs or surgery initially. Ask if you have any physical condition that would prevent you from seeking alternative help. If X-rays or other testing are in order, begin there. Then, depending on test results, your next step is to request a referral to either a chiropractor, the physical therapy department of your local hospital, a sports medicine specialist, or a nearby pain clinic. Based upon your wishes, it is crucial your physician work with you to reach a satisfactory solution to this important issue.

Consider a second opinion, learn your options, perhaps begin a regimen of light exercise under the guidance of a trained therapist. I admire you for considering options other than drugs and surgery. You’re already on the right track.

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.