Painful side effects are a real bone of contention
QI’M 95 and had osteoporosis for more than 20 years. I have been treated with alendronic acid and calcium for about 15 years, and on my doctor’s advice discontinued the alendronic acid about three years ago.
A bone density scan a few months ago showed my bones had got thinner, so I started taking monthly ibandronic acid.
After a couple of months I got the most terrible pain in my upper back, just below my shoulder blades and still need really strong painkillers. I haven’t had an X-ray, but I wonder if the bone pills are to blame. Should I stop them?
AOSTEOPOROSIS is a silent process where bones gradually become thinner and at increased risk of a fracture. It’s a problem that is common, especially in older people, affecting around three million people in the UK.
Unfortunately once bones have become thin there is no cure that can make them strong again, but treatment with bisphosphonate drugs, such as alendronic and ibandronic acid, can help to stop them becoming thinner, and in some people may build up just a little new bone.
Unfortunately there is evidence that prolonged use of bisphosphonates can alter the bone-making process and may lead to the development of weak bone that is more prone to fractures. For this reason, most doctors suggest they are taken for about five years and then bones should be re-assessed.
For those who have severe osteoporosis it may be worth continuing longer than this, but usually on the instructions of a specialist. Though most people with osteoporosis are aware that they are more likely to break their hip or wrist if they have a fall, another common problem is a “crush fracture” of the bones of the back, when they become so weak they collapse under the weight of the body.
This is most likely to happen in the thoracic region, where the ribs attach and can cause severe back pain. I wonder if this is what has happened to you. This can be diagnosed by an X-ray of your spine. If it is the case, you would probably benefit from seeing a bone specialist, who may suggest that you have more powerful injection treatment, rather than taking tablets by mouth. You should also have your vitamin D levels checked.
This is needed to absorb in to
the bones. Vitamin D mainly comes from sunlight on the skin and levels tend to be low at this time of year.
QI HAVE been experiencing a painful burning feeling on my palate for about six months now and it makes it difficult to concentrate on anything else though, oddly, the sensation gets better when I eat and drink. My dentist said the roof of my mouth looked very slightly red and inflamed but he couldn’t suggest anything except changing my toothpaste, which hasn’t helped. My GP hasn’t been able to offer any solution either. What should I do?
AA BURNING sensation in the mouth can be caused by a lack of saliva (a dry mouth), by acid reflux from the stomach and also, less commonly, by low levels of iron or vitamin B.
Infection with thrush can also occasionally be to blame, especially in people who use high doses of steroid inhalers for asthma, so it is worth discussing with your GP whether any of these might be to blame, especially as your dentist thought your palate looked a little red. However, if there is no detectable underlying cause it may be a condition known as burning mouth syndrome.
This is thought to be due to a change in the way the mouth sends messages to the brain and can be treated with drugs used for nerve pain, such as amitriptyline or gabapentin. These can be prescribed by either your GP or a specialist in oral health.
QI’M a 72-year-old man taking medication for Type-2 diabetes, high blood pressure and raised cholesterol. Recently my left arm and hand have been vibrating or shaking and sometimes my left foot joins in, but only when I am relaxed. The tests my GP has done haven’t shown anything and he doesn’t know what is wrong. What do you think?
ATHOUGH there are lots of different causes of tremor, the first thing that came to mind when reading about your symptoms was Parkinson’s disease.
Symptoms usually start gradually in people over 50 and it becomes more common with increasing age, affecting about four per cent of people over 80.
The first symptom is often a tremor in one limb or the limbs on one side, which is worse at rest but absent during activity. The tremor may continue for months or years before it affects the rest of the body. Parkinson’s is caused by a combination of degeneration of cells in a part of the brain known as the substantia nigra, together with low levels of chemical dopamine. It can be diagnosed by a special scan of the brain and treated with drugs that boost dopamine levels, such as levodopa, ropinirole or pramipexole.
Go back to your doctor and discuss whether you would benefit from seeing a neurologist.