Some Frequently Asked Questions, first published in SAGA Magazine (1)
Professor George Lewith
I’m having increasing trouble lifting my arm because of pain just below the shoulder and it hurts when I change gear in the car. My GP doesn’t seem interested – do you think massage would help?
Massage might be helpful as pain is almost always generated by muscles
that are tight or in spasm, but first it is essential to get a clear
diagnosis. The pain may be coming from a problem with your shoulder,
or possibly with the neck. A physiotherapist, osteopath or chiropractor
would be able to diagnose most common problems that affect in the muscles,
bones and joints in the neck and shoulder region.
If it is a shoulder problem then it is really important to keep your
shoulder moving otherwise you could end up with a “frozen shoulder” with
months of pain and discomfort. If the problem is coming either
from the neck or shoulder then massage, conventional painkillers, or
herbal remedies such as Devil’s Claw, with some acupuncture, physiotherapy,
mobilisation or manipulation would all be appropriate ways to treat it. Conventional
painkillers can sometimes cause upset tummies and herbal medicines, such
as Devil’s Claw and Bromelain can often be quite valuable in treating
these conditions. Acupuncture is also very good at treating pain
in the muscles, bones and joints. This kind of pain is rarely dangerous
and it is possible that you may just be able to gently “work through
it”. However, if the pain is worse on coughing or sneezing,
and in particular if it causes tingling and odd sensations in the arm,
you should see your GP, as you may have trapped a nerve and may possibly
have a nerve root irritation from a prolapsed (slipped) disk in your
neck.
During a bout of illness some years ago, I lost weight and have never regained it. I’ve joined a gym and the trainer told me it’s worth taking a nutritional supplement to help build some muscle. Are they any use? I don’t want to look like a body builder, but would like quick results.
My first response would be to be very wary of any quick fix solution to gaining weight. Instant “six packs” tend only to occur in Hollywood films. The first thing to consider is your diet. Are you eating enough, especially enough of the foods that are likely to put on weight? I’m not suggesting you eat cheese, fish and chips and chocolate all day, but try to have more carbohydrates, bananas and nuts. If you don’t do exercise then a planned exercise regime will certainly put on muscle. There are some supplements that some sportsmen use, such as Carnitine, which are said to put on muscle bulk, but my advice is not to use these in the long term, although they may well be safe in relatively small doses for a month or two. It could be that the illness has left you with an inability to absorb vitamins and minerals properly and that is why you are thin; perhaps it has unmasked a food intolerance. Complementary medical approaches, such as looking at food exclusion and possibly some homeopathy or herbal medicine to help your digestive system, might also be very appropriate once a proper diagnosis has been made.
A friend recommends acupuncture to help me give up smoking. Does it work and, if so, how?
The evidence for acupuncture is that it does seem to help withdrawal from most long-term addictions. It seems to act by triggering the production of opium-like chemicals (endorphins) in the brain and this can certainly relieve cravings. Acupuncturists apparently believe that there is a specific “point” that helps smoking withdrawal; unfortunately this isn’t the case, and this leads some people to say that therefore it doesn’t work. In fact it is the expectation of having acupuncture that triggers the opiates in your brain, and this is what may just tip the balance in smoking withdrawal. Overall, the effect of acupuncture is much the same as the effect of many other smoking withdrawal treatments, such as nicotine gum, hypnotherapy and counselling, in that between 10-15% of people have usually stopped after six months. I suggest you use acupuncture as part of your withdrawal programme but don’t depend on it exclusively.
I’m fed up with having to take repeated antibiotic courses for cystitis – is there any effective, non-drug treatment?
If you have recurrent cystitis repeated antibiotics often don’t help. The symptoms may settle without them and there are some good old-fashioned remedies such as drinking lots of water and taking a mixture of potassium citrate that you can buy from your local pharmacy; this alters the acidity of the urine and may be enough to relieve your symptoms. If you have repeated bouts of cystitis the first question to ask is why? Sometimes muscles round the bladder and the vagina become a little floppy after childbirth and you can get a small prolapse. This may increase your susceptibility to cystitis. A pessary, or even some local hormone cream, can help, as can pelvic floor exercises. Sometimes the feeling of cystitis can be associated with recurrent thrush (a fungal infection of the vagina); so if necessary, you should either treat that with a cream from the chemist or consult your GP.
Cranberry extract (that is a herbal extract, not just cranberry juice, which is sometimes full of sugar) can help to sterilise the urine and prevent cystitis. You need to keep taking the cranberry for about three to six months, as it will eventually “sterilise” the urinary tract and things will settle down. Uva Ursi is herbal remedy that has traditionally been used for the treatment of acute cystitis. While there is some evidence for herbal remedies, there is little evidence for homeopathy, largely because there have been so few clinical trials, but many homeopaths claim that cystitis can be well treated with remedies like Cantharis (also available from pharmacies and health food stores). If you are going to use a homeopathic remedy for an acute condition it is best to buy a 6C potency and take the remedy every hour or two until the symptoms have settled for 48 hours.
Years ago I remember taking tablets called Sylvasun to prevent sunburn – I think they were vitamin A. They disappeared, but is there a modern equivalent?
In general it is a very bad idea to take medication like Sylvasun; this was withdrawn from the market because of adverse reactions. Vitamin A probably doesn’t help to prevent sunburn and in any event it is not wise to take too much of it unless there is a medical reason to do so.
It is interesting that the Australians have been conducting an advertising campaign for many years, trying to keep people out of the sun to prevent nasty skin cancers like melanoma. They have been successful, but they have now realised that normal exposure to sunlight is good for you, particularly because it promotes the production of vitamin D, which helps to keep your bones healthy. As always the argument is moderation in everything, so a little bit of sunlight tends not to do you any harm, unless you have got a major sensitivity to it.
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