EDITOR’S NOTE: Physicians, providers, and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in Healthwise Maui, which appears on Thursdays. Maui Health operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealth.org/healthwise.

Q: When is the right time to start palliative care?

Dr. Chad Farmer, Maui Memorial Medical Center Palliative Care Program Director and Hospice Maui Medical Director: Palliative care is specialized medical care that focuses on managing symptoms and improving quality of life for people living with serious illnesses. It’s not the same as end-of-life care, or hospice. It can be started at any age and at any stage of your condition, and you can receive palliative care while also continuing treatment to cure your illness.

When you begin palliative care, you will be connected with a care team that may include doctors, nurses, social workers, and chaplains, who will work in coordination with your regular healthcare providers. Your team can help you get relief from a variety of symptoms, including:

· Pain

· Fatigue

· Nausea

· Constipation

· Loss of appetite

· Breathing difficulties

· Anxiety and depression

· Insomnia

· Weakness

· Cognitive problems

They can also provide support or connect you with resources to help address emotional, spiritual, and practical needs, such as housing or family concerns.

You may benefit from palliative care if you:

· Have a serious illness like cancer, heart disease, COPD, Parkinson’s, Alzheimer’s, or kidney failure.

· Experience symptoms that cause you discomfort, distress, or interfere with your daily life.

· Have had multiple hospital visits due to your condition.

· Want help making treatment decisions or navigating complex care.

Starting palliative care early — even on the day you’re diagnosed — can mean better outcomes in managing your symptoms, reducing stress, and improving your quality of life. There’s even evidence that people with life-threatening conditions who start palliative care sooner may live longer.

Remember, palliative care is different from hospice. Hospice is for patients who are no longer seeking a cure and are near the end of their lives. Palliative care can start at any time, even if your condition is not terminal.

The bottom line is that palliative care is about living as fully and comfortably as possible with your condition. Talk with your doctor about whether palliative care is right for you.

Q: Can sciatica be cured?

Dr. Travis Glenn, Family Medicine, Glenn Family Medicine: Sciatica is a common condition caused by irritation or injury to the sciatic nerve, the longest nerve in the body. It’s often caused by a herniated disc, spinal stenosis (narrowing), or other conditions that press on the nerve. This can cause pain, numbness, or tingling that starts in the lower back or buttock and radiates down one leg.

The good news is that most cases of sciatica do get better over time. Up to 90% of people recover with self-care or conservative treatment like rest or physical therapy. That means sciatica can usually be effectively managed or even resolved without surgery.

Treatment typically focuses on relieving pain and restoring mobility. Milder cases may respond well to rest, cold or heat therapy, gentle stretching, and over-the-counter anti-inflammatory medications. Physical therapy is often a key part of recovery. A trained therapist will work with you and teach you exercises to strengthen your core and improve flexibility, reducing pressure on the nerve.

If pain persists, your doctor may recommend prescription medications, such as non-opioid medication for nerve pain or corticosteroid injections to reduce inflammation. Surgery is rarely needed, but it may be considered if symptoms are severe, don’t improve with other treatments, or if there are signs of nerve damage, such as weakness in the leg. When surgery is needed, it is typically performed using minimally invasive techniques like a discectomy or laminectomy.

With appropriate treatment, most people recover fully from sciatica and are able to return to their everyday activities. Staying active, maintaining good posture, and building core strength can help prevent it from coming back.

Talk with your doctor about the best treatment options for you.