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Neurology Now:
Department: Ask the Experts

Your Questions Answered: SHINGLES

Saper, Miroslav Backonja M.D.

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Miroslav Backonja, M.D., professor of neurology at the University of Wisconsin—Madison, is director of research and education at the university's Pain Treatment and Research Center.

QI have pain shooting from my lower back down my leg. Is there anything I could do about this?

A lot of people assume that any time you have pain going down your leg, it's due to sciatica. But there are other possibilities. First, it's entirely possible that the pain is transitory. Frequently this type of pain results from overused muscles. This can happen, for example, when a “couch potato” plays golf over the weekend or chops logs on vacation. The pain will resolve in a couple of days with some stretching and some anti-inflammatory medications, such as ibuprofen or naproxen sodium.

Figure. DR. MIROSLAV...
Figure. DR. MIROSLAV...
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If the pain is more long-lasting, you should see a physician.

As it turns out, the vast majority of patients who show up in their doctor's office with pain radiating down the leg have myofascial pain syndrome. In fact, this was one of the causes of John F. Kennedy's lower-back pain.

The syndrome isn't well understood, but can be easily diagnosed because patients will have specific “trigger points,” which are spots on the body that are especially tender to the touch. Physical therapy can help with this syndrome. Your doctor may also want to find ways to improve your sleep since poor sleep is thought to contribute to the problem.

It's very important to seek medical advice if you have back pain plus some other medical symptoms, such as fever, chills, or blood in the stool or urine. This could be the sign of a serious medical problem.

If the back and leg pain comes with certain other symptoms—such as loss of coordination or numbness in your legs or feet—then you might well be experiencing sciatica.

That condition results when the root of the sciatic nerve is compressed. This generally happens as a result of a combination of arthritic changes in the vertebrae coupled with a disc protruding into the spinal canal through which the nerves pass.

If you have sciatica, your neurologist will be able to determine what's the best course of therapy. This could include pain management or even surgery.

©2006 American Academy of Neurology

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