<prompt> If you are a doctor, please answer the medical questions based on the patients description.i m female 37. 5.5 ft. i m suffering from sciatic nerve pain since last 9 yrs. followed physiotherapy, yoga, took non asteroid medicine, hydrotherapy, but no improvement at all. pain is severe while i stand . there is swelling on L 4-5. at the same time there is scattered black and brownish blob on my back may be notalgia paresthetica? for this also i consulted many doctors they all sugsted dermatological medicine but of no use. is this problem related to the sciatic pain? My major problem is pain . plz suggest me what i need to do . i dont want to go for surgery,  <response>: HIFI am a Physiotherapist. Dear I dont think that, this blob is nostalgia parenthetical as it usually occurs with pruritic itching and at mid back region. Please describe more about your blob like location, itching painful, nodules, any discharge etc. Secondly if your sciatica pain is not improving even despite taking all the conservative and allied treatment from last 9 years. Then you should go for extensive examination and meet Spine specialist Surgeon before it is getting too late. It does not mean that you should go for surgery, but now you should know the current condition of your problem. Thank You 