DEAR DR. DONOHUE: Please address sciatica. I have it but don’t know much about it. My wife says I should take time off work and stay in bed. Would rest hasten healing? – R.B.

ANSWER: Sciatica (sigh-AT-ee-kuh) comes from an irritated sciatic nerve, the body’s largest and longest nerve. The sciatic nerve originates in the lower back. Nerve roots springing from the lower spinal cord intertwine to form the right and left sciatic nerves. Each nerve travels downward through the buttocks and legs to reach the heels.

Irritation of the nerve anywhere in its long path causes pain. Typically the pain is in the lower back and buttocks and often runs down the back of the leg.

A bulging disc in the backbone is one cause. The backbone looks like a stack of blocks with small sponges (discs) between adjacent blocks to act as shock absorbers. The center of the disc is a gel material, and it can protrude through the disc and press on back nerves. Spinal stenosis is another cause of sciatica. That’s a narrowing of the spinal canal that often comes with aging.

No, you should not go to bed. If the pain is unbearable, one day in bed is allowed; two, at most. Bed rest does not hasten recovery, and it weakens muscles and bones.

Tylenol or anti-inflammatory drugs (Advil, Motrin, Indocin, Naprosyn and on and on) can bring a lessening of pain. Time is the healer for most.

The best sleeping position is on the side with knees drawn toward the chest and a pillow between the knees.

A physiatrist (fizz-EYE-uh-tryst) (not psychiatrist), a doctor who specializes in rehabilitating people, can devise a program that restores back health and ends back pain.

The newly published pamphlet on back problems has other hints on how to cope with this common complaint. Write to: Dr. Donohue – No. 303, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am an 87-year-old woman in full possession of my faculties and without any significant health problems. Why, then, do I drool? It is most embarrassing. What can be done about it? – J.S.

ANSWER: Drooling often happens to older people who are infirm and unable to care for themselves or to people with certain illnesses such as Parkinson’s. You have neither, but you have the problem.

Make a conscious effort, as often as you can, to swallow the saliva in your mouth.

There are treatments, but many have side effects worse than the condition. Low doses of radiation directed at the salivary glands lessen saliva production. Drugs such as atropine or glycopyrrolate (Robinul) also put a lid on the salivary glands. Tying the duct of the salivary glands or moving the duct to a position farther back in the mouth are two surgical solutions. The latest treatment is Botox injections. It appears that there are no illnesses for which Botox is not used.

Your dentist or an ear, nose and throat doctor can give you more specific suggestions.

DEAR DR. DONOHUE: Is it possible to get gallbladder cancer? I have a friend who just passed away, and the cause of her death was gallbladder cancer. – S.W.

ANSWER: Gallbladder cancer exists, but it is most unusual. Huge textbooks devoted to cancer hardly give it more than half a page.

It is a deadly cancer because it’s one of those cancers that have few symptoms until they have gotten large and have spread to distant body sites.

Some of its symptoms include abdominal pain, weight loss, continual nausea and a yellowing of the skin.

DEAR DR. DONOHUE: My son wears sunglasses all the time. Do they hurt his eyes when he wears them inside? – J.T.

ANSWER: They won’t hurt his eyes, inside or outside. Make sure his glasses block ultraviolet light. Then they will preserve eye health.

DEAR DR. DONOHUE: I am a 70-year-old woman, and I have back pain. It began about six months ago. I treated it myself, but I finally decided that I had better see my doctor. I did. X-rays were taken, and the doctor read me the report. It said I had a slight degree of scoliosis.” The doctor told me this was the cause of my back pain, and nothing could be done. He told me to take Tylenol. Why can’t something be done? I am a very healthy 70-year-old. — F.M.

ANSWER: Normally, the backbones — the vertebrae — line up with one backbone directly above the one below it. There is a slight forward curve to the backbone in the neck and in the lower back.

In scoliosis the backbones make an S-shaped curve, the backbone deviating to the side.

Scoliosis is a relatively common condition and one that is usually spotted in childhood. In children, depending on the degree of the S-curve, watchful waiting, bracing and surgery are the options. Children’s bones are still pliable, and their scoliosis can often be corrected or its progression slowed.

Seventy is not old. It is not, however, the age when most scoliosis is discovered. Braces do not often help a bend in the backbone of a 70-year-old. I have not heard that scoliosis surgery has ever been offered to a person of that age.

Your X-ray report said “slight scoliosis.” I have a difficult time swallowing the explanation that slight scoliosis is the cause of your back pain. How about a second opinion? An orthopedic surgeon or a rheumatologist (a doctor specializing in the nonsurgical treatment of bone and joint diseases) is the doctor to see.

There has to be a better explanation for your back pain, and there is medicine for most back trouble. Physical therapy is another avenue to explore for back pain control.

The newly published pamphlet on back pain serves as a guide to the more common causes of it 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 $4.50 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

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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