HEALTH MATTERS: In most cases, people with back pain respond to conservative treatment

Q. I have been experiencing lower back and hip pain that shoots down my right leg. I had this problem before, and it was resolved following physical therapy. But now it’s back. Would you suggest that I see a doctor, a chiropractor, or what?

A. Back pain is quite common. Most of us experience it at least once in our lifetime, and it is a common cause for missing work. In most cases it resolves on its own, with just time. Prolonged bed rest is no longer ordinarily recommended for acute back pain, although severe pain is often helped with a short period of rest. Most back pain is caused by strain of the back muscles, but certain features suggest a more serious cause, such as a bulging disk. Other serious causes include narrowing of the spinal canal, infection and tumors. Features that are more worrisome include bowel or bladder problems, fever, weight loss, and pain or weakness that shoots down one or both legs, just as you describe. I too had similar pain last December, and mine turned out to be due to a ruptured disk. I tried rest, anti-inflammatory medications, an injection into the area of the disk, and nothing worked. Finally, after three weeks of pain, I had surgery, with marked improvement in my symptoms. I still have mild discomfort, but nothing like what I had before. My case is not typical — most sufferers respond to conservative therapy. So I’d certainly suggest a conservative approach first, unless you have weakness or loss of sensation in your leg. But I would certainly see a health care provider soon, whether a physician, physical therapist, or chiropractor. Good luck with your problem; the odds are you’ll be feeling better soon.

Q. I was recently diagnosed with Bell’s palsy after I suddenly experienced weakness of the muscles on one side of my face. I was afraid that I suffered a stroke. Just what is Bell’s palsy, and what’s the outlook?

A. Bell’s palsy is a sudden paralysis of the main nerve going to each side of the face, called, naturally enough, the facial nerve. The cause is unknown, but is presumed to be due to an inflammation of the nerve itself. It occurs in about one in 2,500 to 10,000 people, typically between the ages of 30 and 45 years. Most patients recover completely, but full recovery can take months to up to a year. About one in three victims have residual problems such as continued facial weakness or pain as a consequence of the palsy. Early treatment within 72 hours after onset of symptoms with a medicine called prednisolone (a type of corticosteroid) has been shown to improve the likelihood of a full recovery, so I would encourage anyone who experiences facial weakness to seek immediate medical attention, and probably treatment if the cause is Bell’s palsy. The bottom line for you is that your symptoms likely will resolve over time, especially if you were treated with medication.

Wynne is vice president for health affairs at UND, dean of the School of Medicine and Health Sciences, and a professor of medicine. He is a cardiologist by training.

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The content of this column is for informational purposes only and does not substitute for professional medical advice or care. The information provided herein should not be used for diagnosing or treating a health problem or disease. If you have or suspect you may have a health problem, you should consult your health care provider. Never disregard professional medical advice or delay in seeking it because of something you have read in this column.

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