Ask the Doctor: sciatic nerve, diet problems and plugged ears

Dr. Rob Riley joins us each week from the South Bend Clinic. Here are his responses from August 20th.

Lena: I would like to know with all the medical advances, why can’t they fix the sciatic nerve? I have suffered with this for years.

Unfortunately, the truth is we’re not very good at fixing any nerves and it’s an area of ongoing research. The sciatic nerve starts with nerves in the lower back which go down through the muscles of the buttocks and proceed down the leg. People with sciatica can experience pain anywhere along this path. The problem is pressure on the nerve somewhere along the way. It can be from a disc in the back, narrowing of the spinal canal, narrowing of the opening where the nerve comes out of the spinal canal, or pressure from the muscles it goes through in the buttocks area. Fortunately, most people get better with time and the use of anti-inflammatory medications and perhaps physical therapy. If that’s not working, we’ll often do advanced imaging studies like MRI to try to figure out just where the nerves are being pinched. In those cases, sometimes surgery is necessary to relieve the pressure on the nerve and reduce the pain.

Julienne: What are better choices to eat when pasta, rice, potatoes, and bread are out of your diet?

The foods listed are all the starchy foods. They contain a lot of carbohydrates and really aren’t essential to a healthy diet. For most everyone, we encourage a diet that’s rich in fruits, vegetables, and whole grains and light on meats and sweets. This type of meal plan is rich in nutrients, vitamins, fiber, and anti-oxidants. It also tends to cause people to eat fewer calories per day and many of us would be healthier at a lighter weight. There’s also evidence now to suggest this type of diet may help to lower the risk of several types of cancer and of heart disease. If you’re used to eating a starchy diet, it’s likely to take some adjustment to get used to the new meal plan, but you’re likely to be healthier in the long run.

John: How long should you wait if one of your ears feels like it’s plugged up?

It depends. If the ear feels plugged as part of an acute illness like a cold, that plugged-up sensation is likely to go away by itself, typically in 7-10 days as the other cold symptoms resolve. So it’s OK to wait those out as long as there’s no pain in the ear. But if you’re otherwise feeling well and have that plugged-up sensation, then it may be because your ear canal is plugged up with wax. We see this a lot and it’s something we can fix quickly in the office just by removing the wax. So there’s really no benefit to waiting in that case. Just see your doctor and get it fixed. Many people I see with this problem use those cotton swabs to try to keep their ears clear of wax. That really makes the problem worse as it tends to push the wax further into the ear canal where it builds up over time, so stay away from those if you’re prone to this problem.