Ask the doctor - aches and pains

Brunette woman in pain with her hand on the base of her neck

Click here for the main Ask the doctor page, with questions and answers from our magazine doctors on 25 health topics

I get cramps in my legs after exercise. How can I prevent this from happening?
Make sure you warm up and cool down properly before and after exercising. Your cramps could be due to dehydration, so drink plenty of uids. Low levels of calcium and magnesium may also contribute, so have more low-fat milk, cheese, yoghurt, nuts, seafood, dairy products, wholegrains and dark green leafy vegetables. Try Co-enzyme Q10 tablets, (£13.49 for 50 high-strength, 100mg capsules, www.healthspan.co.uk), which improve oxygen use in cells to reduce cramping. I’d also suggest investigating magnetic therapy, which increases blood circulation in the area to reduce cramping. You simply place a sticky magnetic patch over the muscle involved, use a magnetic leg wrap or wear magnetic jewellery. A wide range of magnetic therapy products is available at www.energetix.tv.
Dr Sarah Brewer, Prima (Mar 12)

The painkillers my doctor prescribed for my sciatica don’t seem to be helping. Do you know of any better treatments?

Sciatica is pain from a nerve root in the lower back becoming trapped. Strong painkillers are usually needed to control the pain, so don’t be afraid to let your doctor know the ones you are taking don’t help. Osteopathy or chiropractic treatments are often more effective in treating back pain and related problems than standard medicine. Both types of practitioner use their hands to manipulate the spine with rapid, direct yet gentle thrusts to re-align muscles, tendons, ligaments and joints. This strengthens the body’s nerve supply, corrects poor alignment, eases tension and promotes relaxation. The key to the success of these adjustments is in the speed, dexterity and accuracy with which they are performed. Ask your doctor to recommend a practitioner locally. These complementary treatments are usually only available privately – expect to pay £50 or more per session.
Dr Sarah Brewer, Prima (Jan 12)

I love my high heels but I’ve started getting pain in the soles of my feet after wearing them for more than a few hours. The balls of my feet feel sore. Help!

Several conditions can cause painful feet, but it sounds like this is probably related to the high heels rather than a medical problem. However, if the pain also occurs when wearing flat shoes, do see your doctor. You may find it helpful to use gel shoe inserts. And at the end of the evening, when
your feet start to ache, try Rollasoles (£8.50 from www.missselfridge.com) ballet-style pumps that roll up tight so you can tuck them into your
handbag, ready to slip on.
Dr Sarah Brewer, Prima (Nov 11)

I’ve started taking in washing to help make ends meet and have noticed I’m getting a lot of fatigue and tension in my shoulders from carrying heavy loads and standing doing the ironing. Is there a way of relaxing these muscles?
Try to take regular breaks so you’re not ironing continuously for more than 20 minutes. Stop to shake your arms and sit down to rest. One of the most effective ways to reduce muscle tension is to massage the area. Or try using the Kneader, a handheld device designed by a massage therapist (£25 from www.kneadsmust.com). Herbal remedies help to relieve tension too, try Vitano (£13.27 for 30 tablets from www.schwabepharma.co.uk).
Dr Sarah Brewer, Prima (Nov 11)

I have had severe back pain for years. Surgery isn’t an option because I have other health problems, and although the painkiller I take, oxycodone, does help, the side effects are dreadful. Are there any better drugs available?I fractured my coccyx when skiing last year. It still aches, especially at night. Can anything be done?
Back pain is one of the most common causes of time off work in the UK. Physiotherapy, keeping your weight down and occupational therapy involving adaptations to your home can all help. Surgery can be effective for some patients, although, as in your case, it may not be suitable. Patients may need to take strong painkillers, but side-effects including constipation, bloating, nausea and tiredness can be a huge barrier – two in five people taking oxycodone have to stop because of these. However, a new kind of painkiller called tapentadol (only for severe pain) is as effective as oxycodone, but just one in five people has to stop taking it because of the side-effects mentioned above. It acts partly on the pain generated in the nerves and partly on the way the nervous system processes pain messages.
Dr Sarah Jarvis, Good Housekeeping (Sept 11)

Can excess fruit acids affect your joints? I eat lots of tomatoes and am getting pains in my hands and knees, and wondered if they could be the cause.
Tomatoes belong to the nightshade family of plants, which contains certain chemicals that may cause joint pains in some people. The only way to know for sure is to avoid foods from the nightshade family for two or three weeks to see if this helps. This means not eating tomatoes, cape gooseberries, potatoes, aubergines, sweet peppers, chillies, paprika,cayenne or products containing them, such as ketchup, chutney nd Tabasco sauce. If you then reintroduce these foods, and the pains in your joints come back, you have your answer.
Dr Sarah Brewer, Prima (Aug 11)

I have diabetes – does this mean I shouldn’t take glucosamine for joint pain?
Because glucosamine is made in the body from a sugar, there has been concern that it might affect glucose control in people with diabetes. However, a three-month trial found no differences in glucose control between a group of people with diabetes who took a placebo or daily 1500mg glucosamine hydrochloride, plus 1200mg chondroitin sulphate (to help boost joint repair). But, as always when taking a new supplement, it is vital to monitor glucose levels in case your medication needs adjusting.
Dr Sarah Brewer, Prima (Dec 10)

I’ve had a painful Achilles tendon for two years, and so far nothing has helped improve it. A friend recommended shockwave treatment, but my GP hasn’t heard of it. Is it worth paying for privately?
Problems with the Achilles tendon behind the heel can cause pain, stiffness and weakness. At the moment, doctors recommend a combination of anti-inflammatory tablets, rest, physiotherapy and special shoe inserts. Surgery tends to be a last resort, but extracorporeal shockwave therapy (ESWT), is worth considering if your symptoms haven’t settled with other treatments. Shockwaves are applied through the skin, and the theory is that this stimulates a healing process. It’s not widely available on the NHS yet, but NICE (the National Institute for Clinical Excellence) has approved it in limited cases for conditions such as plantar fasciitis (pain under the heel), tennis elbow and certain shoulder problems.
Dr Sarah Jarvis, Good Housekeeping (Oct 10)

I was put on statin tablets two months ago, and since then I've been getting vague muscle aches. They aren't severe, but are certainly having an impact on my day-to-day life. Could this drug be doing me more harm than good?
All medicines have side effects, and statins are no exception. A recent survey suggested that up to one in 12 people might be getting regular muscle aches from them. Like blood pressure medication, statins are ‘preventive' - they slash your risk of heart disease, but there's no short-term benefit. However, if you stopped them without asking your doctor and then had a heart attack, it would be too late to wish you had persevered. Do talk to your GP before you stop them, because there are other options. You may be taking other medicines that interact and increase the side effects. Or, because not all statins are the same, you may find that changing to another brand would work as well without the side effects.
Dr Sarah Jarvis, Good Housekeeping (Apr 10)

I keep getting a sharp, shooting pain in my lower ribs. Do you have any idea of what it could be?
It's possible that you have pulled a muscle or ligament in the chest wall. This can cause a sharp pain called precordial catch syndrome (PCS). Another possibility is inflammation at the end of certain ribs (Tietze syndrome) - both of which are relatively common. However, it's impossible to say until you've been checked by a doctor. All recurrent chest pain should be taken seriously, so do make an appointment to see your GP.
Dr Sarah Brewer, Prima (Feb 10)

The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit netdoctor.co.uk