DEAR DR. DONOHUE: My lower back has kicked up on me for quite some time. The doctor tells me it’s spinal stenosis and that I have to learn to live with it. I take Tylenol, and it helps me some. Can anything more be done? — L.H.

ANSWER: Spinal stenosis is a common cause of low-back pain. It also can cause neck pain and pain in the upper back. It depends on what part of the spine has narrowed. The meaning of “stenosis” is “narrowing.” The spinal cord is filled with nerve cells and connections to the brain. It’s only the width of the little finger. It’s very delicate. It manages to stay intact because the backbones encircle it and protect it. It runs from the neck to the lower back in a tunnel, the spinal canal, that courses through the backbones (vertebrae). The spinal canal narrows for many reasons. One is thickening of the ligaments of the backbones. Another is arthritis with the growth of bony spurs. A narrowed spinal canal compresses the spinal cord to cause pain.

Compression in the lower back leads to back pain and pain that travels to the buttocks or down the legs to the back of the thighs and calves in particular. Standing or walking worsens the pain. Sitting relieves it, as does bending forward at the waist, as people do when pushing a shopping cart.

If pain relievers like Tylenol, Aleve or Advil work for you, stick with them. The doctor can prescribe stronger painkillers if they’re needed.

Physical therapy will keep your back limber and might possibly relieve compression on the spinal cord. Your doctor has to make a referral for you.

Back injections with cortisone — epidurals — reduce inflammation, which can open the spinal cord enough to alleviate pain.

Surgery is an option, but save that for last.

The booklet on back pain presents a comprehensive picture of the problem, along with its treatment. 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 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Do people die from diverticulosis? I am told I have it, but it hasn’t been any problem for me. My sister tells me of her friend, who supposedly died from it. Is that possible? My sister loves to pass on information of this sort. — M.A.

ANSWER: With diverticulosis, tiny sacs formed from the colon’s lining are forced through the wall of the colon so that they project from the colon into the abdominal cavity. Diverticulosis causes few symptoms.

Inflammation of the sacs, however, is quite painful. That’s diverticulitis.

I have never known a patient who died of diverticulitis, but it’s a remote possibility. One of the inflamed diverticula could burst and release bacteria into the abdominal cavity. That’s a serious infection with a potential to be deadly. It doesn’t happen often.

Say hello to your sister for me.

DEAR DR. DONOHUE: My tongue has a black coating. It looks hideous. It doesn’t hurt. What’s going on? — S.K.

ANSWER: Black tongue’s appearance is much worse than its health implications. Tiny projections called papillae that cover the tongue have elongated. Usually, their tips are shed. It’s a benign condition. Brushing your tongue with toothpaste on a soft toothbrush three times a day should rid you of it.

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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