My back pain is so severe I’m scared it will stop me walking
THE GP WHO’S ALWAYS HERE FOR YOU
I WAS diagnosed with spinal stenosis three years ago and am in constant pain. My painkillers are useless but my doctors won’t give me anything stronger. I even had injections in my spine but they didn’t work. I saw a neurosurgeon a few months ago but I haven’t heard anything since. My back is getting worse, and I am afraid that one day I won’t be able to walk. Can you advise me?
SPINAL stenosis is a condition that causes back pain because the nerves are squashed by a narrowing of the spinal bones.
It can be horribly debilitating and hard to manage. Often this is about combining treatments and can include things such as antidepressants, which can have a painkiller action. Doctors try to avoid strong painkillers for a chronic pain condition, due to the risk of addiction if taken long term, or side effects such as falls in the elderly.
But when someone’s quality of life is reduced by pain, it is worth having a discussion where the patient is allowed to weigh up the risks and the benefits of at least trying a stronger medication.
Tablets are not the only way to treat pain. In fact, when pain is a chronic issue, it is wise to look at other options. Cognitive behavioural therapy can be good and may help with changing the way you respond to pain.
Pilates and other low-impact exercise may also help because of the movements themselves and the endorphins released by exercising. Pain clinics may also recommend alternative measures for pain, such as acupuncture.
Surgery may be an option but setting realistic expectations is vital. An operation can offer false hope of relief, so honest discussions are necessary.
I HAVE a condition called immune thrombocytopenia, where my blood has low levels of platelets. It started four years ago after what I thought was flu but now think was Covid. I’ve been in hospital three times in the past year. I had bad side effects from injections I was prescribed so I’m now taking a drug called avatrombopag. Can I do anything else to increase my platelet count?
THROMBOCYTOPENIA describes a low level of platelets — the component of blood that helps it clot. Really low levels can lead to easy bruising and serious bleeding because the blood can’t clot when it needs to.
It happens when the immune system mistakenly targets platelets and breaks them down.
Managing platelets can vary from monitoring people with mildly low levels to treatment from a haematologist in more serious cases. The aim is to raise the number of platelets in the blood and maintain a normal level — but this can be tricky to achieve by yourself.
There are no known foods to raise platelet count and you should avoid taking supplements as they can interfere with treatment or the condition.
I HAVE had four urinary tract infections (UTIs) in eight months. In each case I was prescribed antibiotics and the symptoms disappeared, only to return after a few weeks. Later I was offered topical HRT used vaginally, which seems to have helped, plus D-mannose tablets, cranberry tablets and oral probiotics. But I’m worried the problem will keep coming back.
POST-MENOPAUSAL women can often experience urinary problems. A nightly low-dose antibiotic is often used. With a first infection, it is fine to prescribe antibiotics without a test.
For recurring symptoms, lab testing is essential to find out which type of bacteria is causing the infection and make sure the right antibiotic is being offered.
If the same bacteria is picked up in subsequent tests, the infection may be chronic, so some women are advised to take a low dose of antibiotics every day, long term. The drop in oestrogen at menopause affects the genital and bladder systems, causing dryness or a change in function such as poor urine control — which can be mistaken for a UTI.
A trial of topical HRT, an oestrogen cream applied to the vaginal area, is the correct option to treat these symptoms.
Urine symptoms after the menopause can, in rare cases, be a sign of ovarian cancer and a pelvic ultrasound may be ordered.