1 month ago
For respective years I’ve suffered from little backmost pain. In nan past twelvemonth I’ve had MRI and CT scans, X-rays, a colonoscopy and ultrasound scans, which recovered only immoderate degeneration of nan spine. The symptom seems to amended erstwhile I get up, but it’s location each nan clip and is affecting maine badly.
Nadine Taylor, Southport.
Dr Scurr replies: It sounds for illustration you’ve had a broad group of investigations yet, contempt that, you don’t person an nonstop diagnosis.
I wonderment if nan rumor is facet associated arthritis, because from nan benignant of tests you’ve had, it seems different communal causes of little backmost symptom astatine your property (you opportunity you’re 73), specified arsenic a collapsed vertebra owed to osteoporosis aliases a slipped disc, person been ruled out.
The facet joints travel successful pairs - 1 connected nan apical and 1 astatine nan bottommost connected each broadside of nan vertebrae - and stabilise nan spine.
One action for backmost symptom is simply a surgical process known arsenic rhizolysis, utilizing radio-frequency ablation to destruct nan nerves starring to nan joints
Osteoarthritis — aliases degeneration — of nan facet joints is common, and nan immense mostly of adults complete nan property of 60 will person it to immoderate extent.
Yet nan grade of discomfort and symptom will vary. Some group pinch facet associated deterioration acquisition small successful nan measurement of symptoms, pinch conscionable a spot of stiffness perhaps; others are crippled by chronic pain. (In old-fashioned terms, nan symptom mightiness person been described arsenic lumbago.)
Treatment, typically, is pinch non-steroidal anti-inflammatories, physiotherapy and, astatine times, different complementary approaches specified arsenic acupuncture aliases tai chi.
If these don’t help, different action is simply a surgical process known arsenic rhizolysis, utilizing radio-frequency ablation to destruct nan nerves starring to nan joints.
The master first injects section anaesthetic into nan affected joint. If this instantly resolves nan pain, it confirms nan problem is facet associated arthritis — and past radiofrequency ablation is performed, bringing symptom alleviation that whitethorn past for years.
I’d urge asking your GP aliases physiotherapist specifically if nan scans showed facet associated arthritis. If so, you should beryllium referred to a spinal surgeon.
I aftermath up astir mornings pinch a stuffy chemoreceptor and I sneeze a lot. It disappears by astir midday — but I’ve sewage into nan wont of taking an antihistamine and a acold and flu pill each greeting to extremity it. Is this safe agelong term?
Gina Knight, East London.
Dr Scurr replies: The truth that taking an antihistamine appears to power your symptoms leads maine to reason that your symptoms are owed to allergic rhinitis — inflammation successful nasal passages.
Antihistamines are a type of supplier known arsenic anticholinergics, which inhibit nan action of certain encephalon chemicals and see tricyclic antidepressants and narcotics utilized to dainty Parkinson’s.
There is grounds linking immoderate of these narcotics to dementia if taken agelong term, though I tin reassure you that regular antihistamine usage is not implicated. But I wonderment what’s causing your night-time nasal allergy; it could beryllium feathers successful your pillows aliases duvets and/or location dust.
It’s not different to create an allergy successful adulthood triggered by, for example, a viral infection aliases nan menopause; immoderate benignant of alteration successful your immunology that ‘switches on’ an allergy gene. I propose vacuuming cautiously connected and nether your mattress and nether nan bed, and dusting each surfaces regularly (the proposal is to do this doubly a month).
You could besides effort utilizing an anti-allergy nasal spray astatine nighttime alternatively than an oral antihistamine, if you do want to debar a semipermanent anticholinergic. The astir effective are corticosteroid sprays specified arsenic beclomethasone.
As pinch immoderate medication, specified sprays tin person their ain side-effects, principally excessive nasal drying and nosebleeds (stop utilizing nan spray if you experience either of these).
I’d move to utilizing this astatine nighttime and successful nan morning. After a mates of months, you’ll beryllium successful a position to comparison its effectiveness pinch nan antihistamines.
Alarming crab emergence successful younger people
In immoderate diligent pinch gut symptoms, colon crab is ever astatine nan backmost of my mind, immoderate their age. I erstwhile missed nan lawsuit successful a 28-year-old — he was moving successful nan U.S. and phoned to opportunity he’d had rectal bleeding connected a fewer occasions.
I said it was apt to beryllium haemorrhoids and that while he should spot a specialist, location was nary unreserved to do this earlier his return to nan UK. But erstwhile I sent him for investigation a period aliases truthful later, it turned retired to beryllium cancer.
In caller years there’s been an upsurge — unexplained — successful bowel crab successful younger people, arsenic Good Health reported 2 weeks ago. Worryingly, cases are besides rising successful older people.
Screening is nan best, and often main, measurement to observe bowel crab early, and early test equates pinch cure. There’s now a humor trial that looks for nan DNA from crab successful nan bowel, aliases from intestinal polyps that mightiness move malignant.
When it’s rolled out, this trial will prevention lives. In nan meantime, if you’re offered nan location trial disposable for 56 to 74-year-olds, please return it up. And if you’re younger, don’t disregard a alteration successful bowel habits aliases bleeding, which are nan main symptoms.
