DEAR DR. DONOHUE: I am 84 years old, and I have spinal stenosis, which is causing me pain. I would like to know more about it. Will you furnish more information? — T.P.

ANSWER: Spinal stenosis is a common back problem of older people. It’s said that 20 percent of those older than 60 have it. The spinal cord is an offshoot of the brain, and it travels from the brain to the lower back. It’s about the width of your little finger and is extremely delicate. That’s why nature encased it in backbones — vertebrae. Running through the backbones is a tunnel, the spinal canal that serves to protect the cord.

Spinal stenosis is a narrowing of the tunnel. It happens mostly in the neck and lower-back regions. Thickened ligaments surrounding the spinal cord or arthritic changes of the backbones impinge on the spinal cord or the nerves that spring from it.

When the process occurs in the back, pain is felt there and often in the buttocks or thighs. The pain worsens if a person stands for too long. People can ease the pain by bending forward at the waist or by sitting down. Bending opens the tunnel to give the spinal cord some breathing room. The amount of bend that works is the amount of bend a person assumes when pushing a shopping cart.

Have you tried Tylenol (acetaminophen) for pain? It’s safe when used as directed on the label. Nonsteroidal anti-inflammatory medicines such as ibuprofen (Advil) and naproxen (Aleve) also are helpful. They can cause stomach upset and stomach bleeding, so follow directions given for their use. Hot packs or cold packs might work. Try both, and see if either gets the job done. At night, lying on your side in bed with a pillow between your knees lessens pain. A program of physical therapy might help you turn the corner. Ask your doctor for a referral. And finally, the opinion of a back surgeon will let you know if any surgical technique can bring you relief.

The booklet on back pain offers other advice for the many conditions causing back pain. Readers can obtain 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: I am writing in regard to your explanations of glucose measurements. Did I understand you to say that the fasting blood sugar is 126 mg/dL before the diagnosis of diabetes is made? I’ve been told it should be less than 100. And I thought that the cutoff for hemoglobin A1C is 6 not 7. — B.W.

ANSWER: Normal fasting blood sugar (plasma glucose) is a reading of less than 100 mg/dL (5.6 mmol/L). A reading of 126 (7.0) or higher is diabetes. Values between those two levels are considered prediabetes — not diabetes, but likely to become diabetes if steps are not taken.

The normal hemoglobin A1C is less than 5.6. Prediabetes is a reading of 5.7 to 6.4. Diabetes is 6.5 and above. However, for monitoring diabetes control, the ACCORD trial found that a level of 7 is acceptable and is less dangerous for patients. Hemoglobin A1C gives an idea of what the blood sugar has been in the past three months.

DEAR DR. DONOHUE: You diagnosed J.C., an auto mechanic with unbelievable headaches, as having cluster headaches. I think you should have encouraged him to see a neurologist. My son had extreme headaches and was diagnosed with cluster headaches. When my son’s headaches continued to worsen, his family doctor did refer him. An MRI confirmed he had a brain tumor. My son lost his battle with brain cancer last August. — T.P.

ANSWER: My sincerest condolences on the loss of your son — a tragedy.

Headaches that persist or headaches whose diagnosis is not close to 100 percent indicative of a benign process do deserve further investigation, and an MRI (magnetic resonance imaging) scan often is part of such an investigation.

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

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