DEAR DR. DONOHUE: I have had a backache and pain down the back of my left leg. I can work, but I can’t do much physically. How long is it safe to delay seeing a doctor? – B.R.

ANSWER: Back pain and pain shooting down a leg make a good case for sciatica.

The sciatic nerve is the body’s largest and longest nerve. It begins in the lower back, where nerve shoots from the spinal cord intertwine to form the sciatic nerve, which runs from the lower back to the foot.

Sciatica is an irritation of that nerve. The irritation is often a protruding back disc that impinges on the nerve. The irritation causes pain, and the pain is often felt the whole length of the nerve. It has some unique attributes. It is often worse at night. Coughing aggravates it, as does prolonged sitting.

Aspirin or ibuprofen (and the many related drugs) can calm the irritation and afford some pain relief. Anyone with sciatica should sit far back in a chair with a firm back support. The legs should not be crossed over each other when sitting. When standing, one leg should be resting on a footrest or some other such object. Alternate legs. When driving, it helps to put a rolled-up towel between the lower back and the seat. The seat should be moved close to the steering wheel so that hips and knees are bent.

The best sleeping position is on the side with a pillow between the knees. If a person must sleep on the back, then a pillow should be placed under the knees.

Physical therapy is something too often forgotten when it comes to sciatica or back pain in general. An individualized program of exercise and stretching can rehabilitate the back more quickly than keeping it at rest.

The good news is that 80 percent of sciatica patients will see a resolution of their pain in six weeks. If the pain is incapacitating, see a doctor now.

The pamphlet on back problems goes into greater depth on the causes of and treatments for back pain. Readers can obtain a copy by writing: Dr. Donohue – No. 303, P.O. 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 have fluid in one of my testicles. It was withdrawn but returned in two days. In my medical book, I read about injecting a sclerosing solution. Can you advise me about this? – A.K.

ANSWER: Toward the end of fetal maturation, the testicles descend from their position in the abdomen into the scrotum. They take with them a double-ply covering. In later life, fluid sometimes accumulates between the two plies, and the condition is called a hydrocele (HI-drow-seal).

A hydrocele is a painless (usually) swelling on one side of the scrotum. The doctor can ascertain if it is a hydrocele by shining a flashlight at it from behind. If it is a hydrocele, the light passes through the translucent fluid and can be seen shining through the front.

A hydrocele can come from an infection or from a tumor. If pathological conditions can be ruled out and if the swelling is not so great that it causes pain or interferes with movement, then many doctors tell their patients to ignore it.

If it presents problems, then it can be drained and a substance injected that causes the two plies of the hydrocele to adhere to each other. That’s the sclerosing solution. A urologist can give you the details.

The hydrocele can also be surgically removed – a fairly straightforward, uncomplicated procedure.

DEAR DR. DONOHUE: I have pea-sized lumps under my skin, mostly on my torso. The doctor doesn’t know what they are, but he can move them and is not worried about them. Any ideas on what they might be? – K.J.

ANSWER: I am as stumped as your doctor is.

However, there is a relatively simple way to find out what they are. The doctor can remove one and submit it for microscopic examination.

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.

Copy the Story Link