PAIN is one of the most common things readers ask me about.
We all experience it now and again, and some live with it daily.
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A new ache should be investigated if it does not go away after 12 weeks with standard care, such as painkillers.
There could be an underlying cause, such as arthritis or nerve damage.
Chronic pain, which affects more than one in three of us, continues for longer than 12 weeks, either due to a health condition or despite treatment.
Pain is also one of the most common symptoms of cancer.
Sir Chris Hoy, who recently revealed his terminal prostate cancer diagnosis, said last week that his only symptom was a pain in his shoulder.
Meanwhile, an acute ache that comes on suddenly with no obvious cause, such as an injury, is often a warning.
For example, in the chest – and spreading to the back, arm, neck and jaw – may indicate a heart attack, while abdominal pain could be the gallbladder or appendix.
For sudden, severe pain, call 999.
Meanwhile, here is a selection of what readers have asked me…
HARD ARTERY FEARS
Q: About 18 months ago, I collapsed and then was given a CT scan to see if there were any blood clots in my lungs.
There wasn’t, but a build-up of calcium in an artery to the heart was found.
I was fitted with a 24-hour monitor and the results were OK, but nothing else has been said.
Is there anything I can do to help this?
If I get some chest pain it feels like my heart is racing.
A: I’m glad to hear that there was no blood clot in the lungs, but was the cause of your collapse ever identified?
Regarding the calcium in your artery, you have probably heard of the term “hardening of the arteries”, medically known as atherosclerosis.
This is a fatty build-up – plaque – in the arteries, and the plaque contains calcium.
Atherosclerosis is the main cause of heart attacks, which occurs when a piece of plaque breaks off, a blood clot forms around it and then it blocks the artery, stopping the flow of blood and oxygen to the heart muscle.
This can damage the heart muscle and can be life-threatening.
There’s no need to panic, but I would advise having a conversation with your GP.
They may want to do tests to better evaluate your heart health and perhaps start you on some medications to lower your risk of having a heart attack in the future.
Many lifestyle changes can make a big difference in slowing down the hardening of your arteries, such as doing more exercise, stopping smoking, limiting your intake of alcohol and choosing a healthier diet.
Your GP may want to get advice from the cardiology team to see if they would like to assess the level of calcium in your coronary arteries in more detail too.
Sometimes when a test is done to try and find one thing, it can end up discovering something else just as important that was not even being looked for.
We call this an incidental finding, and sometimes these discoveries can be life-saving.
In your case, knowledge is power, as you now know just how important it is to take measures to look after your heart health.
Good luck with it, and please let us know how you’re getting on.
Tip of the week
IT’S human nature to connect with nature, because it reduces stress levels and enhances our well-being.
Autumn is a beautiful time of year, so make the most of it by going to an open space, sitting on a bench and watching the steam from your coffee for a few minutes of peace
AM I TOO OLD FOR KNEE REPLACEMENT?
Q: I HAD a fall about a year ago and since then have had terrible pain and weakness in my knee.
I have been given cortisone injections every four months but they are not helping now.
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My doctor suggested a knee replacement, but do you think this is OK as I am 82 years old?
I really cannot go on like this much longer.
A: As the pain starting coincided with your fall, the first step would usually be to assess if any damage was caused by this accident.
Did you have any X-rays or scans at the time?
The fact that you’re having steroid injections and being advised to have joint replacement surgery suggests that your GP has diagnosed the issue as osteoarthritis.
Osteoarthritis of the knees is a very common condition and the mainstay of treatment is exercise to strengthen the muscles that support the knee, painkillers, and for some people, joint replacement surgery.
Surgery isn’t something to be worried about just because of age, as long as you are generally in good health.
Waiting lists for this operation can be long, though.
If you haven’t already, I would advise getting support from a physiotherapist to optimise the exercise you are doing.
Also ask your GP surgery if there is an exercise rehabilitation programme available in your local area, such as ESCAPE-pain (escape-pain.org).
These programmes can be highly effective at helping people manage their pain, get stronger and fitter and more healthy in general.
I am aware of multiple cases where people have been waiting for joint replacement surgery but then chose to come off the waiting list as their symptoms improved so much
Q: OVER the last ten years, I have lost around 60-70kg, which has led to lots of unsightly loose skin.
Having it surgically removed is a last resort.
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I’ve seen several clinics offering solutions, however, I can’t find studies identifying the most effective treatment.
I am reluctant to visit a specialist clinic, as they will no doubt try to push a product on me, and my GP only appears to recognise surgery.
What do you suggest?
A: The British Association of Plastic Reconstructive and Aesthetic Surgeons only recognises surgical procedures as effective treatments in treating symptoms caused by excessive skin following huge weight loss.
You will find articles saying there are non-surgical alternatives for excess skin, such as techniques which use infrared or radio frequency waves.
But these only aim to slightly tighten and firm existing skin, not remove it.
Excess skin can cause physical and emotional symptoms and can limit a person’s ability to function well, for example, if skin is chafing.
While the NHS does not fund this type of surgery as standard, there may be exceptions for people who have significant problems, such as struggling with daily activities or if they get repeated skin infections.
As is the case for many NHS treatments, it depends on your postcode.
You are correct to be cautious about how to approach the private sector, but many plastic surgeons do both private and NHS surgery.
If you do choose to go down the private route, here are some pointers:
- Do your research about the different types of ‘body contouring’ surgery to find out your preference.
- Connect with people who have had surgery to find out their experiences and get surgeon recommendations.
- Check a surgeon is listed on the GMC’s specialist register in the area of practice relevant to your procedure, and they are a member of BAPRAS or the British Association of Aesthetic Plastic Surgeons (BAAPS)
- Meet two surgeons – consultations are relatively cheap compared to the price of the surgery, so it’s better to invest in getting the right doctor.
- Take time in making a decision
