DEAR DR. DONOHUE: I am a 78-year-old woman, and five months ago I came down with sciatica in my left leg underneath the buttock. It’s very painful. I’d like to know if there is something that can be done. — S.M.

ANSWER: The sciatic nerve is the body’s longest and largest nerve. It springs from nerve rootlets that emerge from the spinal cord in the lower back. Those rootlets intertwine to form this big nerve. It travels from the back, through the buttocks and down the leg to the foot. Anything that presses on or irritates the nerve in its long course gives rise to sciatica, painful inflammation of the nerve. A bulging back disk can press on the nerve. Arthritic spurs on the spine are another source of irritation. A collapse of a backbone from osteoporosis is another trigger for pain, and the pain can be in the lower back, the buttocks or down the leg to the foot.

Have you tried Tylenol (acetaminophen) for pain relief? Aleve, Advil, Motrin and the many other nonsteroidal anti-inflammatory drugs dull pain and quiet inflammation. Icing the painful back area for 10 to 15 minutes three times a day is another way to numb pain. If ice doesn’t work, turn to heat — hot compresses or a heating pad.

Stretching the back might take pressure off the nerve. Sit on a firm chair with feet on the floor and knees shoulder-width apart. Turn slightly to the left. Then, with your right arm dangling down between the knees and left arm dangling down on the outside of the left knee, bend down to the floor as far as you can and hold that position for five seconds. Straighten up and reverse the process by turning to your right and arranging your arms with the right arm outside the right knee and the left arm between the knees. If this exercise hurts, stop. If it doesn’t, perform five bends each, to the right and then to the left. Do the exercise three times a day.

Five months is a long time to put up with back pain. I’m not sure if self-treatment will do much for you. You need a doctor’s intervention, along with physical therapy.

The booklet on back pain delves more deeply into its causes and treatments. To obtain a copy, write: Dr. Donohue — No. 303, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I had a biopsy done on a red, raised ring on my back. The results indicated cutaneous lupus. My doctor said it is of no concern. End of discussion! I am concerned. Should I be? I keep getting the rings on my left chest. I use a cream, and they go away. Are they warnings of future trouble? — T.M.

ANSWER: Skin (cutaneous) lupus comes in two varieties. One is discoid lupus: violet to red scaly, raised patches mostly on the trunk, face, upper chest and back. When they leave, they might produce a scar or depigment the skin. The second kind is subacute cutaneous lupus. It can be widespread. It leaves without a scar. Neither condition affects internal organs, like systemic lupus does. Both are treated with creams or lotions containing drugs of the cortisone family. You do have to steer clear of the sun. Never go outside without putting on sunscreen.

Neither of these turns into systemic lupus. But your doctor should follow you to be absolutely certain that these two did not spring up simultaneously with systemic lupus. The possibility is slight.

Since you lose the sun’s action of generating vitamin D in the skin, you must get your vitamin D from vitamin D-enriched foods or from a vitamin D supplement.

DEAR DR. DONOHUE: As I understand it, drinking coffee makes a person’s blood sugar rise, and then insulin has to be released by the body.

Does drinking coffee overstimulate insulin production and contribute to diabetes, especially if a person is prone to diabetes? — T.F.

ANSWER: Coffee has turned into a health drink. It’s believed to prevent diabetes. It’s also said to prevent heart attacks and strokes.

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. Readers may also order health newsletters from www.rbmamall.com.


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