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Sciatica -- Big Nerve Causes Big Problems

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    Sciatica -- Big Nerve Causes Big Problems


    Please discuss sciatica and its treatment. Whenever I bend, twist or stand after sitting, a shooting pain originates in my lower back and buttock, and travels down my left leg. Over-the-counter pain remedies like NSAIDs and Tylenol are of no help. -- G.K.
    ANSWER: There is a pair of sciatic nerves, the body's longest and biggest nerves. Nerve roots emerging from the spinal cord in the lower back twist together to form the right and left sciatic nerves. Each nerve travels from the lower back through the buttock and down the leg to the foot. Irritation of the nerve anywhere in its long course causes pain. That is sciatica.
    Often the irritation comes from a spinal disk pressing on the nerve in the lower back. Pain is then felt in the lower back and the buttock, and the sensation shoots down the leg.
    Frequently, sciatica clears in a matter of weeks to two months. If your pain has persisted longer, you should see a doctor.
    While you're waiting to do so, use ice or heat on the lower back for 15 minutes at a time and repeat three times a day. You decide which brings you greater relief. Sit in a chair with a firm back and sit as far back in the chair as possible. When standing, prop one foot up on a stool or small, sturdy box or anything that's handy. As far as pain relievers, you have to find one that suits you. Your doctor might give you a prescription for something stronger than over-the-counter medicines, or he or she might combine a mild pain reliever with a muscle relaxant such as Flexeril or Robaxin. The combination often brings pain relief. If you don't obtain relief, injections of cortisone into the space above the spinal cord can suppress irritation and pain. That injection is an epidural block.
    Don't neglect the help of physical and occupational therapists. A physical therapist can teach you muscle-sparing exercises, and an occupational therapist can show you how to use devices that save your back. The back booklet discusses the many causes of back pain and their treatments. Readers can order a copy by writing: Dr. Donohue -- No. 303, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient's printed name and address. Please allow four weeks for delivery.