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Health and Wellbeing - Head, shoulders, knees and…

12 February 2018

Make sure you’re fighting fit for work and play this 2018. We have enlisted the help of specialists from The Montefiore Hospital in Hove to bring you a top-to-toe health guide. There are self-help tips for eight common problems and advice on when to seek medical help.

Snoring
Falling asleep over your desk because either you or your partner snores at night? Then it’s time to take action. If your Body Mass Index (BMI) is greater than 25, losing weight might help. Alter your sleeping position - use pillows to prevent you from rolling onto your back where you are more likely to snore; eat earlier in the evening and reduce alcohol intake particularly before bedtime; and stop smoking. Treat nasal problems like allergies effectively as this may be causing the snoring.

One in ten people suffer from sleep apnoea and may stop breathing for several seconds while they are sleeping. Seek medical advice if you regularly wake feeling very tried as sleep apnoea can affect blood pressure leading to increased risk of heart attacks or stroke. You may be referred to a specialist for further investigation. Solutions to reduce snoring include topical nasal medications and devices which move the jaw forward and widen the airways. Surgery is a last resort but can eliminate snoring for good. Mr Simon Watts. Consultant Ear, Nose and Throat Surgeon.

Heartburn
Do you suffer with heartburn and embarrassing belching? It is a common problem caused by acid reflux and can also make you feel nauseous and make your breath smell. Reduce the symptoms by losing weight or stop smoking. Don’t rush your meals and avoid food triggers such as onions, spicy food, fizzy drinks and alcohol.

Try to leave at least three hours after a meal before going to bed and sleep with your head propped up at night. Take antacids, available from the chemist, within an hour of eating or as soon as symptoms occur. If symptoms continue, your GP may prescribe acid suppression tablets such as ranitidine and more powerful drugs called 'proton pump inhibitors'. You may be referred for an endoscopy to assess whether there is inflammation of the gut and to rule out other problems such as stomach ulcers or gallstones. Dr Khaleel Jamil, Consultant Gastroenterologist.

Be Breast Aware
Lumps in the breast are not the only signs of cancer. Keep an eye out for: nipple discharge, painful breasts, a rash on the skin or skin puckering, if the nipple has become pulled in or looks different, a swelling in the armpit or around the collarbone. Examine yourself regularly, around a week after your period. This is easier in a bath when the skin surface is soft and slippery to allow the flat of your hand to glide in a circular motion whilst examining the different areas of the breast. Never squeeze the nipples to check for discharge.

The key message is, if it is not normal for you, then see your GP. You will be given an urgent referral to a local breast unit, although the vast majority of ladies referred don't have a diagnosis of breast cancer. Lynette Awdry, Hospital Matron and specialist breast nurse

Tennis Elbow
You don’t have to play tennis to suffer with this condition which causes pain around the outside of the elbow. It’s most common in 30-50 years old and is due to repetitive use of the forearm muscles, either at work or during sport. You might find it painful to fully extend your arm or grip small objects such as a pen.

The first step is to rest your arm and take anti-inflammatories. Hold a cold compress against your elbow for a few minutes every day. Your GP may also prescribe a cortisone (steroid) injection. Alternatively, blood-based injections help repair the damaged tendon and may provide a longer lasting solution to the problem than cortisone. Physiotherapy may also be recommended. Surgery to remove the damaged part of the tendon is reserved for severe cases. Mr Joideep Phadnis, Consultant Orthopaedic Surgeon and Specialist Shoulder & Elbow Surgeon

Arthritis in the Hands
Osteoarthritis in the thumb is the most common form of arthritis that affects the hand, and women are more likely to get it than men. It is particularly common among manual workers, and symptoms tends to start in later life, around the age of 60-plus. The pain, stiffness and swelling extend to where the thumb joins the wrist and can decrease your grip strength and affect your ability to do even simple tasks like turning a door knob.

Dietary supplements such as Glucosamine and fish oils may help, and hand exercises can improve the range of movement. Ice the joint to ease pain and take anti-inflammatories such as ibuprofen. Your doctor may prescribe a steroid injection, or recommend a thumb splint which will help decrease pain, encourage the correct position for your thumb, and rest the joint, especially at night. For more severe cases, surgery includes replacing the thumb joint with a plastic joint to give flexibility. Mr Chris Williams, Consultant Orthopaedic Hand surgeon

Endometriosis
Are you the one in 10 women affected by endometriosis, the commonest cause of pelvic pain? This disease causes heavy periods, and affects the bowel and bladder, making it painful to go to the toilet. And it can also reduce your chances of getting pregnant.

Often women put off going to the doctor because they think the symptoms are normal. It is also difficult to diagnose, and there is often a long delay between a woman going to a doctor about her symptoms and being diagnosed – up to six years on average.  An ultrasound examination or laparoscopy, where a small telescope is inserted into the tummy, will confirm a diagnosis of endometriosis.

Regular exercise and switching to a healthy balanced diet can help. Treatments can include the ordinary contraceptive pill or progesterone hormone to help with pain. For women with moderate to severe symptoms, or who are trying to become pregnant, keyhole surgery usually offers the best results in terms of pain relief and enhanced fertility. Mr James English, Consultant Gynaecologist.

Sciatica
Anyone who has ever experienced sciatica knows how agonising it can be and how it can impact on daily life, even affecting their ability to work (5 million working days a year are lost to back pain). Pain radiates down the lower back into the buttocks, back of the legs to the feet, and it can cause numbness.

It is due to compression of the sciatic nerve in the spine, most commonly caused by a prolapsed disc. In most cases, symptoms will improve with rest, painkillers and time. Use hot and cold packs on the lower spine and try stretching exercises. Avoid lying or sitting for too long as this can worsen the condition.

For persistent sciatica, a nerve root block, injected under X-ray guidance, can reduce the painful inflammation. If this doesn’t help, surgery may be necessary. This involves removal of the disc prolapse which is compressing the affected nerve root. It can be done minimally invasively and usually involves a one-night stay in hospital. Mr Shuaib Karmani, Consultant Orthopaedic Spinal Surgeon.

Knee Pain
A quarter of all UK workers suffer from painful knees and surprisingly it affects those who are desk-bound as much as it does those whose jobs involve heavy manual labour.

Years of poor posture while sitting at a desk increase the potential for knee pain. It starts with pain doing simple activities, such as getting out of a chair or going up and down stairs, but these are warning signs that action should be taken. First, address the position of your chair and desk to prevent you from slouching. Regularly do simple stretching exercises for your hamstrings and quadriceps muscles while sitting at your desk. Maintain a healthy weight to take pressure off the knees when standing. Avoid high impact sports and try yoga or Pilates to make your joints more flexible.  Use ice and elevate your knee when possible to reduce the pain, and take anti-inflammatories.  If knee pain persists, then physiotherapy and a consultation with a knee specialist to rule out other problems, is advisable. Mr Sandeep Chauhan Consultant Orthopaedic Knee Surgeon

Advice from specialists at The Montefiore Hospital, Hove, which was recently awarded an overall ‘Outstanding’ rating by the CQC.

First published in Sussex Business Times, January 2018.

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