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We generally think of the sensation of pain as something we could well do without. When we are more thoughtful we can see the need for pain, but it still seems that pain as a warning sensation is much too severe and too prolonged. However, when we come to examine the situation more closely, we see that there is a reason for this. For instance, let us suppose that we burn our hand. The pain from the burn is sudden, intense, and severe. It overwhelms us and we immediately withdraw our hand. The pain is so intense that this reaction occurs automatically, quite beyond our control, and in the time of a split second. In this way the intensity of the pain causes the immediate withdrawal of our hand and so preserves it from further injury. We are not even given the chance to think about it. Thus, the severity of the pain is essential for its protective purpose. But the pain persists after we have withdrawn it from the flame, and is still so intense that we cannot even bear to touch the burnt area. This is again protective. By not touching it, we avoid bringing infection to the raw burn.

We sprain our ankle. The initial pain is so intense that we involuntarily fall to the ground, and our ankle is thus saved from further injury by immediately putting a stop to the stress which was tearing the ligaments. If we turn our foot in the direction of the twist there is an immediate recurrence of pain. So this movement is avoided and there is no further injury. This state of affairs persists for some days. The painful movement is avoided, and the torn ligaments are left undisturbed so that the process of repair can proceed in a way that would not be possible if the injured ankle was allowed pain-free movement.

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Q. What is a peptic ulcer and why does it have this name?

A. We have briefly talked about the stomach and duodenum, two important sections of the gastrointestinal system. Now, let us look at this area in more detail, for huge numbers of people suffer from horrid little sores on the lining of the stomach and duodenum called peptic ulcers.

If you are interested in how words are manufactured, peptic comes from the Greek peptein which means to digest. So, the ulcers are related to digestion.

There are two forms, those that develop in the stomach which are termed gastric or stomach ulcers, and those which form in the next part of the bowel system, duodenal ulcers. Doctors often write G.U., or D.U. for short, and this is an accepted part of their shorthand system. They may occur in other parts of the bowel, but are uncommon.

Really, an ulcer is an erosion of the surface lining of the organ.

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The word ‘sciatica’ derives from the term sciatic nerve. Sciatic pain is a very specific kind of referred pain, one that is experienced at one or more places along the course of the sciatic nerve, which is the major nerve of the leg (and, incidentally, the nerve with the largest diameter in the human body). The sciatic nerve – one for each leg, of course – starts at the lower end of the spine and continues down behind the thigh. Directly above the knee joint, the sciatic nerve divides into two main branches – the tibial and common peroneal nerves – one branch travelling down the shin to the big toe, and the other running down the back of the calf to the heel before it winds around to the front of the foot and then extends into the toes.

The above is, of course, but a simplified description of the sciatic nerves; if you were to look in Gray’s Anatomy, the classic volume that still remains a standard medical reference nearly 150 years after it was first published, you’d find that more than four pages of small type are devoted to listing all the intricate sub-divisions of these nerves. While little purpose would be served by going into all this detail, it is important to note that almost any part of the leg can be affected by sciatic pain.

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