Creaks and cracks in neck may be due to arthri­tis

Cape Breton Post - - Advice/games - Keith Roach Dr. Roach re­grets that he is un­able to an­swer in­di­vid­ual let­ters, but will in­cor­po­rate them in the col­umn when­ever pos­si­ble. Read­ers may email ques­tions to ToYourGoodHealth@med.cor­nell.edu or re­quest an or­der form of avail­able health newslette

DEAR DR. ROACH: I am an 83-year-old man in rea­son­ably good health. About six months ago, I started hear­ing a crack­ing noise when I turned my head side­ways or up and down. Some­times it would hap­pen ev­ery 15 sec­onds. No one can hear it but me, which is why I haven’t gone to my fam­ily doc­tor. I also have had some light headaches. -- R.P.

AN­SWER: The crack­ing noise could be com­ing from one of the joints in your neck. Most peo­ple at age 83 have some de­gree of arthri­tis in the neck, and I think that’s the most likely cause.

Some­times there can be a snap­ping noise or sen­sa­tion as ten­dons move over a bony promi­nence. Other times, there can be a crack­ing noise, such as crack­ing knuck­les, for the same rea­son, with ni­tro­gen bub­bles form­ing in the joint with pres­sure changes. But a crunch­ing or crack­ing noise most of­ten comes from the joint it­self, and of­ten rep­re­sents some de­gree of arthri­tis. If it’s not both­er­ing you, noth­ing need be done. A set of X-rays could con­firm and de­ter­mine the sever­ity of arthri­tis.

The headaches may have noth­ing to do with the sound, but there are headaches that can be trig­gered from neck arthri­tis.

The arthri­tis book­let dis­cusses rheuma­toid arthri­tis, os­teoarthri­tis and lu­pus. Read­ers can or­der a copy by writ­ing:

Dr. Roach, Book No. 301, 628 Vir­ginia Dr. , Or­lando, FL 32803 En­close a check or money or­der (no cash) for $4.75 U.S./$6 Can. with the re­cip­i­ent’s printed name and ad­dress. Please al­low four weeks for de­liv­ery.

DEAR DR. ROACH: If a per­son has lower than op­ti­mally func­tion­ing kid­neys, and pro­tein is hard for kid­neys to process, is it eas­ier for kid­neys to process plant pro­tein or an­i­mal pro­tein? -- S.H.

AN­SWER: Plant pro­tein def­i­nitely is bet­ter for the kid­neys. Switch­ing from a meat-based diet to a plant-based diet has been shown to slow the pro­gres­sion of kid­ney dis­ease from many dif­fer­ent causes. A plant­based diet has prob­a­ble ben­e­fits in terms of heart dis­ease as well, com­pared with a diet high in an­i­mal pro­tein, es­pe­cially red meat.

Re­duc­ing an­i­mal pro­tein is only part of what needs to be done for kid­ney dis­ease. De­pend­ing on how ad­vanced the kid­ney dis­ease is, some peo­ple need to re­duce the amount of potas­sium they take in. It also may be ap­pro­pri­ate to look care­fully at med­i­ca­tion doses, which of­ten need ad­just­ing in peo­ple with kid­ney dis­ease.

DEAR DR. ROACH: I am an 85-year-old man who has been both­ered with trig­ger fin­ger for a num­ber of years. My doc­tor says I’m in good health for my age. Sev­eral years ago, a doc­tor said he could give a cor­ti­sone in­jec­tion but would not guar­an­tee it to work over a long pe­riod. I had three, and they did not work. What are my op­tions now? -- B.K.

AN­SWER: A trig­ger fin­ger is a con­di­tion where a fin­ger (or the thumb, which is con­sid­ered a fin­ger) gets stuck in the bent po­si­tion, re­quir­ing it to be pulled back into place again. It is caused by one of the ten­dons get­ting caught in a pul­ley sys­tem in­side the fin­ger. Treatment usu­ally in­cludes mod­i­fi­ca­tion of ac­tiv­ity, short-term splint­ing and anti-in­flam­ma­tory drugs, or cor­ti­sone in­jec­tion if that doesn’t work. Only peo­ple who have failed to get re­lief from in­jec­tions should be con­sid­ered for surgery. That’s the choice you have to make now. The surgery is very ef­fec­tive (about 94 per­cent suc­cess rate), and most peo­ple are back to near-nor­mal ac­tiv­i­ties in a week or two.

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