How can I relieve leg nerve agony?

IN 2015 I had a bad fall on my left side. Weirdly, ever since I have woken up with a shooting hot pain – in my right leg – every night about 4am. I have not had a complete night’s sleep for four years. I’ve been prescribed amitriptyline and gabapentin but they don’t work. Can you help?

SYMPTOMS that disturb sleep can be traumatising. Not only do you have to cope with the pain or discomfort, but the exhaustion that comes with broken sleep too.

Shooting and hot pain is typically nerve pain, also called neuropathic pain, caused by nerve damage, and can result from a fall or injury.

Nerves control our sense of temperature, which is why the affected area may feel hot.

Both amitriptyline and gabapentin are prescribed for neuropathic pain.

The dose of gabapentin must be increased gradually for safety reasons, so talk to your doctor about your dose as often it’s not that a medication doesn’t work, but that patients haven’t found the most effective dosage.

Amitriptyline is an antidepressant also used for neuropathic pain. It is taken at night, and doses of up to

75mg are usually effective for relieving pain and helping you sleep. A remedy called capsacin cream, available on prescription and over the counter, can also be useful if a specific area is affected.

An electric shock machine called a TENS machine, also available from pharmacies, helps by counteracting the pain impulses from the damaged nerve.

Ask your GP about a referral to a neurologist. If the damage is correctable, surgery may be able to resolve, or at least improve, the symptoms. I HAD a hip operation 12 years ago and now I read that surgery can leave scraps of metal in the bloodstream, potentially causing problems. Is this true?

IN 2017, the medical authority, MHRA, recommended that hip replacement patients have regular health checks.

But this warning is only relevant if you had a type of hip replacement called a ‘metalon-metal hip replacement’.

Only a small number of Britons had one of these – ask your GP if you did – and most of these 56,000 are fine.

The potential problems are related to the breaking down of the new hip joint – and this causes pain, swelling and difficulty walking.

There’s also damage to the joint, and microscopic metal ions can be released into the space around the hip and into the bloodstream.

Testing the level of metal ions in the blood is a useful way of seeing how much the hip has been worn down and damaged. But it does not mean there is metal in the blood stream.

It is not metal scraps they are testing for, but the ions, which are chemically different and do not cause blood poisoning.

In fact, no link between hip replacement complications and blood poisoning has been proven.

Patients who had metal-onmetal replacements should keep an eye out for chest pain, shortness of breath, fatigue or weight gain as well as changes to sight and hearing.

If you have any concerns, speak to your GP.