How do I rid myself of pain all over the body?

Dr Flo, I am 25 years old and I have a pain problem. I feel pain in my chest and back and sometimes in my ribs.

Sometimes I also feel like my stomach is burning. What causes this pains and which medicine should I take? Emmanuel

Dear Emmanuel,

The burning abdominal pain that also causes chest and back pain is most likely due to gastritis. Gastritis means that the lining of your stomach is inflamed or irritated.

This is usually caused by excess stomach acid and imbalance of some digestive enzymes. When this goes on for some time, it can lead to formation of an ulcer, which is an open wound on the lining of the stomach, the lower part of the oesophagus or the duodenum (first part of the small intestines).

The pain may come when hungry, or just after eating, or it may be worse at night. You may also experience heartburn, a lot of gas in the stomach, nausea or vomiting, constipation, or occasional diarrhoea. If the excess acid is coming back up the food pipe, it can cause throat irritation and pain, cough and a bitter taste in the mouth. If the ulcer is very severe, you may have blood in the vomit, dark-coloured stool, weight loss and severe pain.

Risk factors for developing gastritis and ulcers include excessive alcohol intake, smoking, prolonged use of some painkillers (non-steroidal anti-inflammatory drugs e.g. aspirin, ibuprofen, diclofenac, mefenamic acid), infection with the Helicobacter pylori bacteria, serious illness, radiotherapy in the stomach region or stomach tumours that produce a lot of acid. Some people seem to be genetically predisposed to produce a lot of stomach acid, while in others, no cause is ever identified.

Most times, gastritis goes away on its own, or with medication. The symptoms usually come back from time to time, especially when triggered e.g. by taking some painkillers, binge drinking, staying hungry, taking particular foods, etc.

To manage the illness, stop taking alcohol, stop smoking and avoid use of painkillers like aspirin, brufen, diclofenac, and mefenamic acid. There are also medications to manage the symptoms, including proton pump inhibitors like omeprazole; sucralfate, antacid syrups, and antibiotics (if you have the H.pylori infection).

For some people, particular foods may trigger or worsen the symptoms. These foods are different for different people, and if you monitor your diet, you will know which foods affect you so that you can reduce consumption for now. With proper treatment, you should be able to continue with your diet as normal.

Dr Flo, does sciatica have a cure? If one delays treatment for too long, can it cause permanent nerve damage? Adam

Dear Adam,

The sciatic nerve exits the spine at the lower back, and travels down through the buttocks and thighs, with branches that go all the way to the toes. When you have sciatica, it means you have pain spreading along this nerve. It usually happens because the nerve is compressed by a bulging disc, narrowing of the spine or arthritis along the vertebrae. You can get numbness and tingling, burning pain or pain that feels like an electrical current.

For many people, the symptoms are mild and manageable with self-care. For a few people, the pain can get very severe, and they may develop weakness in the affected limb and problems with bowel or bladder control.

For self-care, exercise regularly, maintain good posture, maintain a healthy weight, avoid sitting for too long, do stretching exercises, and be careful when lifting heavy objects (hold the objects close to the body, bend the knees and lift with your back straight). Avoid excessive physical exertion, and you can use hot or cold packs to ease the pain.

It would be advisable to be followed up by an orthopaedic specialist. There are medications to manage the pain and inflammation. Physiotherapy also helps. Surgery is recommended for those whose pain is severe and does not improve with other treatments, or if there is weakness in the limb or loss of bowel or bladder control.

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