Dear Ask The Doctor: Dear doc, i am a 28yr old man living in kenya. My problem is, i have had severe lower back pain down to my hip since june of 2010, i have been to all kinds of doctors and xrays show that i am ok, i have been reduced to taking 2x400mg of ibuprofen every 4hrs to manage the pain. two months ago, the pain got worse, and to make it worse, it really hurts(my back) when i cough, and i dread to sneeze, because the pain that follows incapacitates me for atleast an hour. Im currently on medication for a chest infection, and am taking 500mg of amoxicillin 3x a day together with the ibuprofen. And i am taking calcium tablets, but the pain has now gotten soo severe, am just in bed. Doc, what can i do? Am frustrated, its been a whole year of pain, and i just want it to stop so that i can leave a normal life. Thanks.
Dear Shadrack: The piriformis muscle can either irritate or compress the proximal sciatic nerve due to spasm and/or contracture. Piriformis Syndrome is also referred to as pseudosciatica, wallet sciatica, and hip socket neuropathy. This might be the cause of your low back and hip pain. Consider the Physical therapy treatment as the first option; it uses ultrasonography and other heat modalities along with the stretching exercises. Before piriformis muscle stretches are performed, the hip joint capsule should be mobilized anteriorly and posteriorly to allow for more effective stretching. A home stretching program should be provided to you. These stretches are an essential component of the treatment program. During the acute phase of treatment, stretching every 2-3 hours (while awake) is a key to the success of nonoperative treatment. You can keep using your tens and also anti-inflammatory medication (“Aleve”, “Motrin”) to control the pain.