Ask the Doctor - March Scotland on Sunday column

Sunday 27th March - Bony Lumps

Mr Daniel Porter is a Consultant Orthopaedic Surgeon at Spire Murrayfield Hospital.

We all have bony prominences which can be seen and felt and are quite normal – in fact it would be abnormal not to have them. Sometimes these normal lumps are felt by patients to be either new or larger than expected. A GP will usually give complete reassurance.

It is more worrying when a definitely new bony lump appears. Features which might cause worry include pain and rapid growth, but even then there is often a reassuring explanation. Remember that a childhood malignant bone tumour is very rare – on average a GP would only see one of them in a century of medical practice.

In a child or adolescent many benign bony lumps are “exostosis” (see picture) which can easily be diagnosed on a X-ray. Around a fracture new bone will usually form a lump known as a “callus” which will disappear over a few months. Any concerns about bony lumps should be checked out by your GP. An orthopaedic surgeon may also be asked to provide an assessment.

Sunday 20th March - Headaches

Elaine Graham is a Physiotherapist at Spire Livingston Physiotherapy Clinic. For further advice regarding assessment and treatment contact 01506 448181.

The short answer is yes, probably, but it may depend on the type of headache.

It is important that you see your GP to rule out other possible causes of headache. However, headaches that have been going on for a long time with no specific diagnosis are often the types that will benefit the most from physiotherapy.

These headaches can often be caused by a problem in the upper part of your neck. Physiotherapy treatment for headaches can include manual therapy to the neck and upper back, acupuncture, relaxation techniques and exercises to strengthen the deep muscles of the neck.

Many headaches can be influenced by lifestyle factors such as stress, posture and work-station set up and advice can be given on managing these issues.

Sunday 13th March - Spinning Room

Mr Alex Bennett is a Consultant ENT Surgeon at Spire Murrayfield Hospital.

The most likely cause of your symptoms would be Benign Paroxysmal Positional Vertigo (BPPV). BPPV is the most common cause of vertigo I see in my Balance Clinic.

The balance organ in the inner ear is composed of three semicircular canals, all at right-angles to each other, which act as “spirit levels” telling the brain which way up you are.

Crystals known as otoliths can become loose within these canals, due to infection or trauma. When you turn, these crystals can move, telling the brain you are turning when you are not, giving rise to the symptoms you describe.

The good news is, the treatment is a straightforward manoeuvre to move the crystals to a safe place rather like a game of bagatelle...

This manoeuvre, known as the Epley manoeuvre, only takes five minutes to perform and has an 85 per cent success rate.

Sunday 6th March - Back Pain

Chris Raeburn is a Physiotherapist technician at Spire Edinburgh Hospitals. Spire Edinburgh Hospitals run classes led by qualified Australian Physiotherapy and Pilates Institute (APPI) Physiotherapists.

Current research that shows that lower back pain can be aggravated by a lack of muscle co-ordination and endurance in the lower back. This can increase the load that is put on structures of the lumbar spine, such as the joints and discs.

Ensuring that the muscles of the lower back have sufficient co-ordination and endurance will  therefore help to spread the load and can ease your pain.

Using these in conjunction with exercises to stabilise and strengthen the core muscles of your trunk can ensure a strong and stable base for all movement, whether for sport or daily activities.   An assessment by a physiotherapist can rule out any specific spinal disorder. Following that, our intensive Back and Neck Physiotherapy programme or Pilates may be recommended to you.