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What is the reason for my mother's back pain?

Dr Debashish Chowdhury
Professor of Neurology,
GB Pant Hospital, New Delhi

Q: My mother, 57 years old, is suffering from back pain, which starts from the lower back on the left side and travels down the left leg and moves up to the left half of the head. She is also suffering from chronic osteoarthritis. She has been operated twice for uterine fibroid. The other problems she has include sleeping sickness, hypertension and hyperacidity. Some doctors say it is sciatica while others say it is due to a pull of mesentery.

A:Your mother's problem seems to be multifactorial. However, the pain involving the nerve roots and the nerves of the lower limb cannot go upto the head. If there is pain in the head, then that is a separate association. Sciatica is an old descriptive term which suggests affliction of sciatic nerve due to any cause, most common being slip disc. Actually, the nerve roots (which originate from spinal cord and then combine to form nerves that supply the body and limbs) get trapped within the small canals (called foramina) and this produces the pain (and sometimes weakness also). These pains have characteristic features like these are sharp, follow a particular road map (called dermatomal pattern) and increases on bending, coughing and sneezing. At your mother's age, the bones in the vertebral canal (called vertebrae) develop small bony outgrowths thereby reducing both the foramina and the canal and thus trapping the nerve roots and the nerves.The abdominal pain (following uterine operation) that has been suggested due to pull of mesentery does not have the character of neural pain as described above. You must take opinion from a good neurologist or an orthopaedic surgeon.