DEAR DR. GOTT: My mother was diagnosed with a herniated disc last year. She was in pain but able to walk. She tried physical therapy, which did not help, and also steroid injections into her back. The first shot helped only a little, and the second did nothing at all. Her legs are now much weaker, and the pain is more intense, and she has to use a wheelchair because of it. Surgery is not an option because of her diabetes, high blood pressure, a partially blocked carotid artery and autoimmune hepatitis. Is there any way to treat her pain and weakness?

DEAR READER: Your mother certainly has some serious health conditions that would likely disqualify her for surgery because of the high risk of complications. That being said, there are still several treatment options she hasn't tried.

A herniated disc is often difficult to treat and can be quite disabling. This is a condition in which one or more of the intervertebral discs of the spine bulges or breaks open. When this occurs, the disc often pushes on sensitive nerves in the spinal cord, causing pain, leg and lower-extremity weakness, fecal and/or urinary incontinence and more. Most sufferers respond well to physical therapy that increases back-muscle strength, which then holds the discs in proper alignment. When this fails to provide adequate relief, physicians move on to prescription pain medications, steroids (to reduce inflammation), pain clinics and even surgery to surgically replace or remove the disc(s).

Chiropractic manipulation is also a viable choice. While many physicians do not recommend this and do not even consider chiropractors part of the medical community, I believe chiropractors can be extremely helpful for certain conditions. These specialists can physically manipulate the muscles, discs and vertebrae of the spine. It may take several weeks or months before results are noticeable, but for many, relief can be experienced within just a few visits.

Exercise is important to keep the muscles strong and well-toned. Water aerobics and strength-building classes under the close supervision of her instructors may help because of the ease of moving in water.

Other options include acupressure or acupuncture. If she pursues this option, she should do her homework. It is important to find an experienced, certified professional who uses clean, sterile instruments.

Relaxation techniques such as deep breathing exercises or yoga may help. Even simple pilates exercises could improve muscle function.

And finally, a pain clinic may be useful. In this instance, doctors, nurses and other medical professionals work with people who suffer from chronic pain in order to find the best treatments. Hospital-run programmes are your best bet for getting a wide variety of choices and disciplines.

To give you related information, I am sending you a copy of my Health Report "Managing Chronic Pain." Other readers who would like a copy should send a self-addressed, stamped No. 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Doctor Gott is a retired physician and the author of the book "Dr. Gott's No Flour, No Sugar Diet," available at most chain and independent bookstores, and the recently published "Dr. Gott's No Flour, No Sugar Cookbook."