Q:

I am 23 years old and have been suffering from low back pain now and then for three years now. My problem has been diagnosed as sciatica or herniated disk. I used to be a construction worker. I have been prescribed medications but they don’t seem to work. I am planning to work abroad and I’m wondering whether this illness will affect my working abilities. What treatment would you suggest?

A:

Sciatica is characterized by low pain radiating down the buttocks and below the knee. This is due to a herniated or protruding intervertebral disk causing nerve root irritation. The most important elements in managing this problem consist of rest, pain relief and patient education. A two-day bed rest is very effective, but for some, it may take seven days to relieve the pain. Pain relief can be provided by non-steroidal anti-inflammatory drugs, such as aspirin or mefenamic acid. You learn how to protect your back from heavy objects, to use legs rather than the back when lifting, to use a chair with arm rests, and to get up from bed by first rolling to one side and then using the arms to push to an upright position (see box). Surgery will be needed for this condition if there is direct evidence from x-ray procedures, a consistent weakness or neurologic deficit.