Aches and pains
Pain in neck
Q . Over the last few months I have been suffering with tenderness and pain in both sides and back of my neck. I have been to see my GP who prescribed only painkillers. There is no obvious signs of swelling but as I have suffered from a Seminoma in my chest (extragonadal germ cell tumour) several years ago, the continuous pain is starting to worry me and I'm not due to see my oncologist for a few months yet.
A. It is very difficult to advise you without an examination and seeing your notes and I run the danger of alarming you unnecessarily as a result. As you know the type of tumour you suffered from is very treatable as has particular places in the body which it is more commonly found. You do have lymph glands in your neck which can get involved in infection and tumours so you do need to exclude this possibility.
However, there are generally tender and enlarged and you can feel them so it is unlikely to be anything nasty. As it is impossible for me to reassure you via this medium I suggest you get in touch with your oncologist and ask his or her advice, even if it is only down the telephone.
Twitches and spasms
Q . Over the last few months I have been experiencing a problem whereby I often get nervous like twitches or spasms throughout various parts of my body, very often in my arms, legs, chest, eyelid and head. I also experience numbness or tingling down the right side of my face, in my hands and feet, both symptoms can last from a couple of minutes to several days and vary in their severity.
A. Such vague sensations are often difficult to pin down. Check your diet to make sure you are getting enough calcium (bread and milk are good sources). Are you overworked, stressed or run down? These are also common causes. There are some nerve disorders which will mimic these kinds of sensations so you should see your GP.
Nausea and arm tingling
Q . Over the last few years I have experienced every few months a strange nausea sensation in my stomach area immediately followed by a tingling or numbness in my arms. The sensation lasts about 30 seconds and then disappears. As far as I am aware the experience always occurs at rest - usually in the morning. I wondered if this is any cause for concern.
A. It is very difficult to find a link between these sensations your describe. On the plus side if they have been going on for so long they are unlikely to be life threatening. Even so I would advise you see your GP if for no other reason than getting them down on paper as you experience them now so that should any changes occur you will be able to compare them and so make finding a cause that much easier.
Groin pain and other concerns
Q . I am quite concerned about the groin pain that my boyfriend developed this morning. I have tried insisting that he let me take him to his doctor, but he refuses saying that it is probably a stone and will pass. The pain is sharp, comes and goes and is in the lower front pelvic area. He is putting out a low volume of urine and he says he feels chilled. He has high blood pressure for which he is taking medication to control. He is 49 yrs. old. His weight is 270 Lbs. and he is 5'11" in height. Also I have noticed that his breath had gotten quite bad over the past few weeks. When I told him about it he visited his dentist who found nothing wrong. Also over the past few months his attitude toward life in general has become quite negative and he has mood swings daily.
A. There are a number of possibilities which can only be eliminated with an examination and tests from his doctor. It sounds as though he may have an infection of his kidney which can be precipitated by diabetes. This might explain his bad breath. It could also explain his mood swings. He should take plenty of fluids, check his blood pressure, blood sugars and have his urine checked for infection. He really must see his own doctor.
Bruised sensation in chest
Q . For the past 4 months I have had a bruised sensation on my chest (breast part).. like I have been hit.. there is no swelling.. no lumps.. just a pain when touched. The left side is fine. The nipple is maybe a little darker. I have no pain on breathing. What can this be ?
A. Unfortunately you really need to be examined to make certain and I would need to know your age. Young men just after puberty can develop very tender nipples on one or both sides. They are incredibly painful when touched or hit. This provides no end of fun for all the other guys who are not suffering from it. It is completely normal and is caused by the changes taking place in the breast tissue. If you are older, say in your forties you need to see your doctor particularly if any lump develops or there is any discharge from the nipple.
Pelvic floor tension myalgia
Q . I have been told that I may have pelvic floor tension myalgia. What is it and how did I get it? What are the treatments for it? If any?
A. Myalgia just means muscle pain so it can apply to any part of the body which has muscle. The pelvic floor is the sheet of muscle which lies just beneath the abdomen and separates it from the lower part of the body above the thighs. Anything which over does it for these muscles will cause pain. As they are involved in the erection, passing water, tensing the abdomen, it can be cause by wham blam sex, going to the toilet too often or weight training. You will need to identify the cause yourself and give it a rest for a while. Anti-inflammatory drugs will help in the short term.
Sudden sharp pain
Q . Lately I have been getting a sharp needle like pain in the tip of my little finger right hand, and it shoots to my chest, on the right side as well. It goes as quick as it comes, but happens three or four times a day. It's started to worry me.
A. I really need more information such as your age, occupation and medical history. Vague pains such as you describe are extremely common and only very rarely indicate something nasty is happening. It would be useful to know when and where they happen. Is it while you are at rest or when you are, for instance, typing? There are repetitive strain injuries (RSI) which are associated with keyboard work and can cause inflammation of the nerves that run through the wrist. This can cause both localised pain at the lower arm/wrist but also referred pain to the fingers which, as you describe, 'shoots up the arm'. I suggest you see your GP who may shed some light on the problem but I do warn you that RSI can be notoriously difficult to treat.
Q . In October 1999 I fractured my tib(and fib(r leg). I also had compartment syndrome resulting in me having to have my leg opened up to relieve the pressure. When my leg couldn't be closed back up, I had to have skin grafting. Unfortunately, I also had to have muscle grafting to cover the metal plate in order that the skin would take. I attended advanced rehab for several months but give up after I seemed to get to a certain point but no further.
At the moment my leg keeps giving way from undeneath me and I get a very severe pain to the left of my shin bone which renders me unable to put weight on it. This only happens occasionaly but I do get general pain from day to day especialy when climbing stairs,walking medium distances, crouching down etc. What I would like to know is are there any prospects of improvement or is this something I am going to have to live with.
A. You have had and are having a bad time. People have this misconception that breaking a leg is a trivial event. As you have correctly pointed out it can lead to immediate and long term problems. You refer to compartment syndrome where the pressure of inflamed muscle in spasm along with blood trapped in the leg threatens to stop all blood flow and crush nerves. The inevitable result is an amputation of the leg. Opening it up is the only real way of releasing the pressure before the damage is done. To do this means cutting through thick muscles which will always be weaker than before. At the same time there may be damage done before the pressure was released. I'm afraid my answer is vague not least because I would need more information to be more precise. Physiotherapy and pain relief is the mainstay. further surgery is rarely of any value and may even make things worse.
Q . Hi. Lately I've been getting burning pains down my legs. Sometimes I will get them down my arms, bottom of my feet. I have told my doctor and he said nothing is wrong. Could you please advise me of what steps could I take.
A. It is very difficult for me to give any definitive advice without seeing your notes and performing an examination along with conducting some tests. One common cause of this kind of problem is a reaction to medication. This includes some of the complementary medicines. It would be worth checking with your local pharmacist if anything you are taking could be causing the sensations you describe. I'm sorry I cannot be of any greater help.
Q . Hi, I am 34 years of age, I've been sick for over a year. I have been the same in a long time. I experience some terrible pains all over my body. There are times the pains drive me crazy. I have had pain from head to toe. As I sit here typing this I am in pain, in my neck and head. I have this burning pain on one side of my head that comes and goes. I have taken lots of tests but the doctors cannot come out with nothing. As they say I look healthy. I do have hypetension and I take Catapres Patch TT1. I need to find a physican or a specialist that will perform a physical of my entire body, not only doing blood work. Sometimes I feel like blood is not floating through my body properly. Please advise me of what step to take.
A. I am taking this very seriously. One of the great problems with modern medicine is trying to look at a person as a whole when the way doctors are taught is to think about specific areas. Without seeing your notes and the results of the tests I cannot make any definitive diagnosis.
A good rule of thumb is that you would not be alive if it was something life threatening. This doesn't help when you are suffering in the way you describe but it does mean that you have time to find out what is really happening. It might be worth looking at the medical history of your relatives, especially mother, father, brother or sister. Depression can mimic many other medical conditions but it can also be diagnosed as a 'catch all' when we don't really understand what is happening. I recommend you sit down with your GP after writing out as you have done here, all the things which are causing you distress. I'm sorry I can't be of any greater help. Please let me know how you get on.
Q . I have been suffering with what I would describe as 'palpitations' - a fluttering feeling - in my chest directly beneath my sternum on and off over the last 3-4 months. It stopped for a while but has started up again over the last week - it now occurs a couple of times a day and whilst it is not painful it is a little discomforting.
When it does occur it lasts for about 15-20 minutes on and off. I do not know whether this is related to digestion or something more serious. Could you advise on what could cause such symptoms?
A. You may be experiencing atrial fibrillation which is very common, is not usually serious and can be treated by your GP if it doesn't respond to simple things you can do for yourself. You may find that your pulse (gently feel your wrist with two finger tips at the base of your thumb) is irregular as well.
Cutting down on booze, getting more sleep, going easy on work or sport and checking your medicines (ask your pharmacist) might well do the trick but you should see your doctor anyway.
It might also be an episode of 'supraventricular tachycardia' which sounds marvellous and is a dead cert to get you a free drink at the bar for simply being able to say it. It is simply a spasm of a very high rate of heart beats which usually settle on their own. It can be stopped and prevented by a visit to your doctor. The good news is that it is rarely dangerous or a sign of nasty things to come but see your own doctor.
Numbness in part of foot
Q . Certain parts of my left foot are numb or have no feeling in them at all. The two areas effected are the tip of my big toe and the base of the heel. I do not have tight fitting shoes and I'm certain that it's not just a case of a trapped nerve. Someone suggested that it might be pernicious anaemia but I don't have any other symptoms. This started some 9 to 12 months ago, initially just the tip of my toe but I've noticed recently that it has SPREAD to my heel. Any suggestions or help would be gratefully appreciated.
A. Scary stuff, but not necessarily the sign of a real nastie. The good news is that you are trying to find out what is happening. Most of us men are quite prepared to wait and see until some bugger is hammering nails in the coffin.
It would be very useful to know a bit more about you, not least your age. Diabetes can cause this loss of sensation, particularly in the feet. If you have any close relatives who are diabetic get this checked out sooner rather than later. Poor circulation can also cause this problem, generally in older men who smoke. There are liver and blood complaints which will produce numbness in your feet but they tend to affect both at the same time. Pernicious anaemia is easily detected by a simple blood test by your GP. You would also generally notice a general tiredness. The best advice is to get checked by your own doctor.
What you describe should not be happening and I do not have enough information to give you a proper diagnosis. Please let me know how you get on after seeing your doctor in the very near future.
Dizzy spells and concern about carbon monoxide poisoning
Q . I am 18 years old, 5'11' and about 65kgs. Slim build, active and a healthy eater. For some time now I have gotten dizzy spells after getting up quickly. Sometimes I have to sit down again right away and a few times I have lost my vision for a couple of seconds and even fitted. I'm worried that it could be low blood sugar levels or bad circulation. Please could you help.
I am also worried about Carbon Monoxide poisoning. We have quite an old gas fire in our front room. Whenever it has been on for a while people often start to feel slightly lightheaded, mild headaches and sleepy. As soon as they get some fresh air they seem to "perk up". I know that you can suffer memory problems as an effect of CO poisoning and can easily say that my memory is far from perfect. I'm not going to wake up and forget who I am, but I keep forgetting simple little things, and things that I was doing yesterday and who with. What's your thoughts and can you buy or rent a CO monitor?
A. My thoughts are you should turn off that fire and don't put it back on again until a qualified gas inspector has checked it. There are hundreds of cases of carbon monoxide poisoning in the UK every year and people do lose their lives. Take this very seriously indeed and do not delay.
You display the classic symptoms of postural hypotension where your blood pressure fails to rise quickly enough when you stand to keep the brain supplied with oxygen and glucose. Most cases are not serious but it is impossible to say what is causing it from your information. I cannot confirm that it may be due to the fire. What I can tell you is that you need to see your doctor and get some simple tests done. Do not delay or put this off until another time. I am talking about now.
Knot on lymph node
Q . My husband has noticed a knot near or on his lymph node. He stated it feels like a burning sensation or a numbness feeling. I could feel the knot without applying any pressure. He is 34 and an active man. I was just curious what someone's opinion on this might be. He isn't one who likes to see the doctor. Thank you for your consideration.
A. As usual it is the woman of the house who sorts the men out! Unfortunately there are many places where you can feel lymph nodes and lots of reasons for them feeling like a knot. I have a sneaky hunch that you are talking about the lymph nodes in the groin. If not, ignore all this and give me some more information or better still get him to his own GP.
If the 'knot' is in the groin and it pulses when he coughs, especially when standing up, it is probably a hernia. This is a small out pouching of muscle or gut from inside the abdomen through a weakness in the body wall where the cords to the scrotum run through. Although not serious you should have him check it out with his doctor. If the 'knot' is a lymph node there can be many reasons for it not least an infection in the limb. There are some more serious causes of swollen lymph glands which is why he should be checked out. Best of luck and don't take no for an answer.
Headaches, dizzy spells and an eye problem
Q . I am very concerned about my partner. For about three months now he has been suffering with headaches, dizzy spells and an eye problem. One eye is red and smaller than the other especially if he is tired or sleepy. He feels faint and light headed most times. He now says he feels pain around his ears and his head feels very sensitive. He has been to his doctor (more than once) and even A&E at the hospital and examinations (quick ones) have revealed his pressure, blood, heart are OK. He also has a slight cough which has been with him for months. He also recently had athlete's foot.
He is never sick and this is so worrying for both of us. Please can you help or give suggestions.
A. Thank you for asking my advice. It is difficult to give definitive pointers without access to more information from your partner's notes. Most cases of the symptoms which you describe have no serious implications for the future - just as well as they are the most common things seen in a doctor's surgery. Even so, you are correct to be cautious as basic tests can fail to pick up some problems until relatively late in the progress of the condition.
Generally speaking a serious condition gets progressively worse with increasing symptoms as it progresses. If, for instance, he is now suffering from double vision along with his headaches, there is any disturbance in his sense of smell or hearing, or he has difficulty in breathing, you need to insist on further investigation.
Eyes are roughly the same size and their size is usually measured by the observer as the amount not covered by the eyelids. Pupil size, on the other hand should remain the same for both eyes, give or take a small degree of difference. Glaucoma will cause severe pain in one eye and the surrounding area and the eye can appear 'bigger' although it usually feels much 'harder'.
Either way I feel he may well deserve a specialist referral and talking frankly to his GP, underlining your fears, should do the trick. Please let me know how you both get on.
Numbness in arms and thighs
Q . I have numbing sensations in my arms, and upper thighs. Sometimes, depending on the position, I will feel a pinching sensation; always in the area of the numbness. What could it be?
A. It is impossible to say without more information. Hyperventilation (breathing too rapidly) will produce this effect but more often in the hands and feet. If it is truly numb there will be no sensation there at all. There are some nerve conditions or lack of calcium which will show themselves this way but you would need to see your GP and give more information and have an examination.
Lots of things in 62 year old
Q . Gentlemen, I am 62 and retired from lecturing at 59. On the year I left I obviously went through some sort of crisis - chest pains, night sweats, tinnitus, what I would now recognise as panic attacks, depression.
My heart is now no problem, I spent 2 years on Stelazine, now changed to 10mg Seroxatine. Now my mood is OK although I still prefer not to be away from familiar ground. I maintain a part time job. I have zero libido and despite reasonable diet and exercise I am too heavy with tummy fat. The tinnitus has never gone away. What has been going on! Thank you
A. You need to focus on some of the symptoms you describe because they are not necessarily related. The two drugs are not interchangeable. Stelazine is mainly for sickness (nausea) and would be appropriate if you have an inner ear problem which could have resulted in your tinnitus. Seroxat, which is what I presume you mean, is an antidepressant and is used for compulsive disorders. One of its side effects is impaired sexual function which is a combination of libido and erectile dysfunction (impotence).
I would separate out the panic attacks, which are very common, from the tinnitus. You may well have had an infection of your inner ear which has left you with the ringing noise and possibly a reduction in your hearing.
Never ignore chest pain although you can suffer these from panic attacks. I suggest you see your doctor about the side effects of Seroxat and see if he or she can prescribe something else. Do not simply stop taking it without seeing them first.
Cramps in legs
Q . Have started getting cramps in my legs during the night. The cramp wears off but my legs have pain for some days. Is this serious or just old age?
A. A great deal obviously depends on what age you are. These types of pain are caused by a lack of oxygen to the muscles but it may be a peculiar condition of night time calf pain for which we do not know the cause. It can be treated with quinine from the GP. If you are diabetic or have any kind of circulation problem, it may be more serious and you need to seek medical examination and advice. Smoking makes the problem worse.
Side effects of prednisolone and tacrolimus
Q . I have recently been diagnosed with retinal vasculitis. Initially I was prescribed Predisolone but the condition did not respond to the treatment. I have been on this drug since June of this year taking approximatley 20 mg per day. Two weeks ago I was prescribed the drug Tacrolimus (2mg twice a day)with the aim of replacing the Prednisolone with this drug. I have started reducing the Predisolone and am now on 10 mg per day. I should be off this medication early in the new year.
My main problem at this moment in time is increased difficulty in breathing. I first noticed the symptoms about 8 weeks ago following a chest infection that lasted about a month. My consultant informed me that the infection and subsequent breathing difficulties were probably due to the Prednisolone. Since commencing the Tacrolimus this problem seems to be getting worse - if I walk too far I get breathless, sweats, dizziness etc. I have checked this with my consultant who informed me that this was normal and the symptoms should ease with time.
Not happy with this I checked both drugs on the intrenet and under the information on side effects it advised me to contact my doctor "immediately" or seek emergency medical attention if I was expereincing breathing difficulties as this could be an indication of serious side effects. I chose to contact my consultant again but was given the same reply - continue to take the medication and the symptoms should ease. I was not happy with his advice and am now considering stopping all treatment as I am worried that continuation will seriously damage my health. I know that if I do stop the medication my vasculitis is likely to flare up again so I find myself in a catch 22 situation. Will these symptoms ease over time? Will they improve after I stop the Prednisolone? Will they continue regardless and affect my long-term health? Please can you advise me on this.
A. Under absolutely no condition must you stop taking the steroids suddenly and without advice. The body becomes very used to the action of the steroid and to a large extent is dependent on their presence to maintain normal blood pressure, kidney function and a clatter of other body functions. If you have been on any steroid for any length of time a sudden stop can be literally lethal.
You are taking two powerful immune suppressants for the simple reason that the retinal vasculits has the potential of destroying your sight. For reasons we are not sure of your own body is attacking the blood vessels of the eye and without them the retina would very quickly be unable to detect light. The danger of internet information is that you cannot interact with the person who has asked for the information. In this case the reaction to the steroids or the Tacrolimus causing breathing difficulties requiring 'emergency medical aid' is an anaphylactic response which happens within minutes of taking the drug and usually from injection. It is unlikely that you have spasm of the bronchus as steroids are used to treat this in the first place. You may be anaemic either from chance or as a side effect of the drugs. This can be checked and rectified.
Do not even think about stopping either of these drugs without first seeing your doctor.
Pins and needles in feet, legs and hands
Q . For the past few months I have started to experience "pins and needles" in my feet, legs and hands if I have been sitting on the floor or working with my arms above my head etc. Can you offer an explanation for this? I am 35, eat well, non-smoker & not overweight.
A. The main clue to your problem comes from your sitting on the floor or working with your hands above your head. Both of these position can cause a lack of blood flow either to your legs (by crossing them while sitting) or to your arms (by having them raised). Most people are concerned quite rightly with high blood pressure. This is a big killer in our society. Low blood pressure is less common and generally less dangerous so long as it doesn't get too low. If you get dizzy when you stand up, for instance, it may be that your blood pressure is too low or that your heart is not responding to the demand for a higher pressure quickly enough. This can be caused by problems within the heart itself or from the effects of medication prescribed for some other reason. Beta blockers, often used for anxiety, are a good example but there are many others. I cannot cover all the possible areas that may relate to your problem without more information so you should see your own doctor.
Pain in groin and flatulence - link?
Q . Several months ago I relocated to another country. Just before I left, I experienced pain in my left testicle which gradually subsided to be replaced with occasional discomfort (no real pain) in the testicle and pain in the left groin area. I also have problems with flatulence and get the strong feeling the groin pain and flatulence are related. I have not changed my (healthy) diet. I currently have mild stress symptoms and at present an unfulfilling sex life. Any ideas?
A. I feel you could benefit from a urologist's opinion for this problem but you may be overlooking a simple explanation for both the flatulence and groin pain. Men can develop a hernia with out realising it. There doesn't always need to be a gut wrenching agony as you lift something heavy. Even sneezing can do the job.
We men tend to suffer most from inguinal hernias as a result of the potential weakness in the abdominal muscle wall just at the groin where the duct carrying sperm passes through. Place two fingers along the crease between thigh and abdomen about two thirds along and give a good cough while standing. A hernia can be felt as a tap on your fingers. If you feel a lump there see your GP as hernias are easily treated but can be dangerous if left.
Pain in buttocks
Q . For the last 2 weeks I have had occassional discomfort on the left side of my buttocks. I can feel it more when I have excess gas.
A. This is probably a type of anal/rectal pain related to a change in eating habits and is most unlikely to be caused by muscle problems in the buttocks. Buttocks are made up of Gluteal muscles to give them their medical name.
Pain in chest on exertion
Q . I am 47 years old and fit and healthy. I recently contracted dysentery but have now recovered. I now find I have a pain in my chest when I climb the stairs or when I increase speed on my bike. Any ideas?
A. If you really did have dysentery you are indeed unlucky. The disease itself can have some effect on organs other than the gut, but it is rare in well nourished people.
What you describe is classic angina, chest pain caused by a poor blood flow to the muscles of the heart. This is often the result of partial blockage of the heart's blood vessels from fatty deposits in their walls. Most people feel fine while at rest but when the heart demands more oxygen during exercise it has a sort of cramp. The pain should subside at rest. Do not try to work through this pain, stop as soon as it comes on. There is an outside chance that your brush with dysentery damaged some of the heart muscle but you will need tests to be sure. Take half an aspirin a day, so long as you are on no other medications or herbal treatments, and see your doctor at the next available appointment.
Tingling hands and fingers
Q . I am 42. I smoke. 5'6" 12.5 stone. My diet is varied. I do not avoid "unhealthy" food and eat as and when and in the amounts I like. I very rarely go to the "Docs" as there always seem more important things to do. I am living with a great deal of "responsibility" both family and work. I am very aware of this "pressure" and can at times feel trapped and even depressed about my situation. I struggle on!
Generally I consider myself fit and healthy. My father lived until aged 90. My mother died of breast cancer aged 44. I am not enjoying my daily life at present which is a great shame because I know I should. My wife is under equal pressure with her job and the kids etc. STRESS!
My question is this. What is the likely reason for tingling in the hands and fingers? Is my body warning me of something? Is it stress or diet related? Or is it due to many years of operating hand held sanders (about 10yrs ago). It wakes me in the morning and I have to hang my hand/arms out of bed to get rid of the pins and needles. I have had it on and off all day today which is unusual. As it is something to do with blood flow or pressure should I see the Quack?
Lots of interesting items on your site.
A. This quack has some good news for you - or at least about your hands which I will deal with first. There is an occupational disease from vibrating tools which causes loss of power, loss of sensation and shaking. This without doubt could be part of the problem, but what you classically describe is a very common condition called 'carpal tunnel syndrome'.
The tendons of the wrist are held in place by a broad band of ligaments. This is supposed to stop the tendons from bowing out when the hand is flexed. For some reason this band can thicken and press on a nerve which runs just underneath it. It usually happens in one hand first, often to be followed by the other. It is not serious although, if left, it can cause permanent muscle loss in the hand. Steroid injections are favoured by some doctors but surgery is both simple and very effective. It can be performed under a local anaesthetic.
Stress is linked to many conditions and while it might not cause them all, it undoubtedly makes them worse. Coping with stress is a far more realistic option than the impossibility of trying to avoid it in the first place. Former Chief Medical Officer, Kenneth Calman, once said that he did not suffer from stress himself but he was a carrier. As both you and your wife are stressed you will be adding to the problem rather than easing it. There is good advice on coping with stress in this site.
The fact that your father lived to 90 is a very important factor for your own life expectancy. This is spoiled to some extent by smoking which increases your risk of early clog popping by at least a factor of 2. Even so, quantity is not as important as quality and you need to look very carefully at what it is that is spoiling your enjoyment of life at present. You may find this easier if you go away with your wife for a mini break and have someone else look after the kids if possible. Yes, there is always something more important to do than see your doctor, but you have at least one very good reason for doing so and you might get yourself a good check up at the same time. I would nip down there, quack as you like.
Bee sting and lymph nodes
Q . Approximately a week ago I got stung by a bee in store, a day later I got small lymph nodes on the back of my neck, not behind the the ear. Do you think these are lymph nodes? What can cause the lymph nodes (or the bump) to come up like that? What common virus can make lymph nodes swell like that?
A. There is a ring of lymph nodes around the base of the hairline at the back of the neck. There are also some at the side of the neck at the angle of the jaw just below the ear. All of them will pick up infection from the scalp or neck.
Bee stings in themselves are not dangerous unless you are allergic to them. Even if you are not, there will always be some inflammation, especially if the sting carries any infection. This will cause a swelling and tenderness at the lymph node which is first in line for drainage from the sting site. A classic cause of raised nodes around the base of the hairline is scratching. After any form of bite or sting this is very common and serves to increase the amount of inflammation. In answer to your questions, yes it probably is a lymph node and it is not a virus that has caused it.
Pain in groin
Q . Pain in left groin, no sign of swelling, pain down front of thigh, great diffcultity in raising leg to get in car etc, sometimes have to lift leg with hand as cannot raise it by itself. I have not done anything to have caused this, job to stand and sit, does not hurt too much when walking or on short trips. Does not seem to improve with rest. Painkillers do not seem to work. It has been like this for 5 weeks now. Any ideas?
A. Obviously it is difficult to be certain without an examination and more information, but you describe a problem not with your thigh but rather your back. It looks as though you have pressure on the femoral nerve which supplies the muscles of the front of the thigh to the knee. It also picks up signals from pain sensors, so you may also feel a numbness alternating with pain only as far as your knee.
There are many causes of this but pressure from a prolapsed disc is a common factor. Injury to your spine may also cause pressure on the nerve. There are more serious but rare causes such a tumour from the prostate but you would almost certainly have other symptoms such as reduced urine stream and/or blood in your urine.
Whatever the cause you need this sorted out and I recommend you visit your GP ASAP.
Q . I suffered from unsteadiness on occasions, particularly when (1) looking up (2) stiff or cold shoulder/neck (3) turning my head to the right side when in bed (4) getting out of a car. Nowadays I do not drive. Diagnosed some years ago as a trapped vein or nerve. On occasions but not regularly I take Betahistine (8MG). Nearly 80 years of age. Is this a condition I have to put up with and manage the best way I can ?
A. The first thing that hits me is a confirmation of a little known fact: The biggest growth in web users is amongst older people. Thank you for making a 50 year old man feel like a novice.
What you describe is classic for the aging process' effect on the spine. You are experiencing a tightness on the two arteries which pass through the neck spinal bones to supply the brain. Brains are totally dependent on glucose and oxygen and any shortage of either, for even tiny amounts of time, impairs its function. Further restricting the flow of blood by looking up makes matters worse.
There are surgical treatments to free the blood vessels and you need to discuss this with a specialist as the surgery is not without risk. Drugs have little effect or help. My dad is 80 years old and he has lost his leg through vascular problems. He sounds a bit like yourself, wanting more of life rather than just a pat on the head. You may not get much help with this problem from us doctors but by God, you will never get a pat on the head from this site!
Numb toe tip
Q . The tip of my left big toe has been numb for the best part of the last six months. My GP wandered off on the pernicious anaemia route without any success. Can you give me any indication as to what this is? A trapped nerve perhaps or is this a far too simple explanation?
A. Without more information and an examination there is little hope of giving you a definitive diagnosis so you must pursue this with your own doctor. Even so, some things do come to mind including anaemia but a great deal depends on your age and any underlying medical conditions.
If your toe is both numb and cold, with a blue colouration, it is more likely to be poor circulation. This can be the result of many things not least diabetes. A simple loss of feeling at the very tip can be caused by as simple a thing as poorly fitting shoes and wearing sandals can produce dramatic effects. Neurological conditions tend to be more general but if there are transitory feelings of numbness in other parts of the body you should report them to your doctor. I'm sorry I can't be more specific without more information.
Q . I was wearing 2 pairs of gloves in the chilly weather last night whilst riding home on my bike (about a half hour journey). My fingers were extremely cold by the time I got home with little or no feeling left in them. It took the next 2 hours sitting in a heated flat to thaw them out. This is something that seems to happen a lot in the cold weather. Even last week when I was playing hockey (again not especially cold) I was the only one on the pitch wearing gloves for any part of the game. I have noticed adverts for a medical condition relating to poor circulation.
What can I do, and are they any natural remedies that can improve the situation?
A. The body has a natural reaction towards cold which has helped us survive at least one ice age in the past. By cutting down on the amount of blood going to the extremities, the hands and feet, the core temperature of the body can be maintained as it limits the amount of cold blood returning to the heart. It does this by 'shunting' blood - short circuiting it - before it reaches the hands or feet. At the same time it constricts the peripheral blood vessels. The net result is a poor blood supply to those places some lagers also fail to reach.
There are some conditions such as Reynaud's Syndrome which makes the protective reaction too severe, the constriction of peripheral blood vessels too fast, stimulated by inappropriate temperatures and lasting for too long. There are surgical treatments which entail cutting the sympathetic nerves which stimulate the blood vessels to constrict, but simply wearing good foot or handwear can help limit the effects of the condition.
Poor circulation from thickened arteries tends to make the problem worse in higher temperatures causing pain during exercise. See your doctor if the simple remedies fail to help.
Q . My dad is 51 years old, about 6ft 4 and weighs about 16 stone. He suffers from an ache in his stomach, sides and back that is constant and is taking 2 painkillers every 4 hours even nightly. He hardly sleeps at all and has been to the doctors numerous times and cannot even get a scan for another 3 weeks. Any ideas on what could be causing this would be much appreciated.
A. I am sorry but with this amount of information combined with a lack of examination it is impossible to give any kind of reasonable advice. Even so, if he is suffering from pain to this degree he really does need further examination. Waiting three weeks for a scan (I presume this is a CAT or MRI scan?) is not unusual and, to be honest, will not make a great deal of difference to the outcome of his diagnosis whatever it might be. Even if you were to go privately I doubt very much if you could have this brought forward. The most important thing meanwhile is to support him and make sure that any diagnosis and treatment as a result, is acted upon with utmost vigour. Best of luck.
Sharp pain when using stomach muscles
Q . I have a sharp pain directly in my belly button which shoots down to my penis. I have had this before, and it went away, but I'm not sure what it is. It only hurts when I use my stomach muscles (quick movements, lifting things, even urinating). There is no lump, and I've had it off and on since I was a boy...Can you help me figure out what's wrong?
A. You might just have a hernia at the umbilicus (belly button). It is rare in adults but common in babies. A small part of the abdominal musculature is weak in this area and closes quite late in development. In some babies it fails to close completely and needs surgical repair. A tiny weakness can go unnoticed and is only apparent as a pain on exercise. If there is no lump present, there is probably no gut protruding through the weakness as in a full blown hernia. Even so you should get it checked as a hernia which strangulates can be very serious. Having said all that, there are very simple reasons for this pain which are not at all dangerous such as early trauma which has sensitised the muscle wall.
Pain and bladder problem
Q . For about the last six months I have had this pain on both my right and left sides right about the kidney area. When I urinate my bladder hurts and the pains increase. The pain intensifies when I am really thirsty and I drink a little more water than I normally would. I have been to the doctor, I had a blood test and they say nothing showed up but the pain keeps getting worse.
Any ideas of what I could have or what tests I could get my doctor to do on me to get to the bottom of these pains so I can get back to normal again?
A. There are a number of different symptoms here and it is difficult to reconcile them all.
The fact that it hurts you to pass urine would suggest a urinary cause for at least some of your symptoms, and it may be that the pain in your back is related. Equally, it is possible that the pain is not coming from your kidneys at all.
To be honest I would recommend that you ask your doctor for a referral to a urologist so that a proper history and physical examination can be performed to try and identify a cause for your problems. This would also give the specialist an opportunity to arrange further investigations if necessary.
Cramps in legs
Q . I am experiencing quite bad cramps in my legs, and I am worried that I may have a circulation problem. I eat quite healthily, although I don't excersise as much as I'd like to. I am 21.
A. Cramp is very common. While complicated, the pain comes from the muscle spasm resulting from a build-up of lactic acid. This happens when the blood is not carrying the waste products of muscle activity away quickly enough or there is insufficient oxygen reaching the muscles in the first place. It unfortunately hits you just at the time when you could really live without it.
Classically, the little toe will cramp while lying in bed. Cramps which come on at rest are quite different from those which occur with exercise, especially in a young man. The classic 'cramp' of claudication in the legs is caused by thickening of the arteries from smoking, diabetes or poor diet. It comes on during exercise and eventually takes less and less exercise to cause pain. This pain usually subsides with rest.
Inactivity can also cause cramps which tend to occur at rest. This has more to do with the low efficiency of the muscle than poor circulation. Simply becoming more active usually sorts this out.
Some mineral deficiencies can cause cramps. Calcium, potassium and magnesium are typical examples. A glass of milk, a banana and raw vegetables will provide the whole lot.
You can check your own circulation by feeling for and comparing the pulses at the back of your knee, ankle and the front of your foot. They should feel the same. Having said that, after all these years of medicine I still have trouble at times finding them in the first place, but don't tell the GMC!
Q . I am 25 yrs old, male, 5"6 weight about 170. As far as I know I am in good health condition. However, from time to time I get a bloody nose. It's been for several years now, but usually when I blow on it hard or if I have been on a plane. Lately I have been getting a bloody nose in the mornings. The bleeding usually stops in a couple of minutes. Since the weather is getting colder we often leave the heater on. Does that have anything to do with the bloody nose? Oh and I should mention I think the problem started a little after I was hit with a ball back in high school. Should I be concerned?
A. People fear nose bleeds because they can be signs of blood disorders or high blood pressure. In fact, if they have been happening for a very long time in a young person the reason is almost invariably not serious.
There is part of the inside of the nose called Lytle's area which has a number of blood vessels very close to the surface. They can bleed without any apparent reason but more so if there has been previous injury to the area. High blood pressure and certain blood disorders will also increase the risk.
In a man of your age with this history it is almost certainly a matter of seeing an ENT specialist who can cauterise the area. Unfortunately it does tend to recur in a few years. Your GP can refer you.
Knee problem, pain on inhalation and feeling down
Q . Like most blokes I don't go to the doctor as frequently as I should, consequently I have three problems I'd like your advice on.
1) I have pain underneath my right knee cap, it's in the right hand cormer of the cap, which is also swollen. I have worn a tubby grip on it for about three weeks but my knee is getting no stronger. It actually feels like something is trapped under there.
2) My right lung is painful when it is fully inflated. When I am taking normal breaths it's fine but if I run of suck in hard it hurts when it's full.
3) I am also worried about my state of mind. From time to time, I feel down and I don't know why, there is often no cause but I can't get out of this mood. It can last for days or weeks but also there are times when I feel fine for ages. It undermines my self confidence which normally isn't a problem.
Thanks for your time and this service, I work too hard to think about the doctor but this is perfect for me.
A. First of all relax. You are in very good company for all of the things you describe. I note your feeling of being down and without doubt this can make any medical condition feel worse. It cannot explain everything about your knee however so we will deal with that first.
You may have suffered an injury earlier in life which has damaged either the tendons, ligaments or even the cartillages which cushion the bony surfaces of the knee. Generally a badly damaged cartillage will cause the knee to lock with pronounced swelling. It is possible, however, to damage them and suffer long term irritation and inflammation.
Ligament damage is very common. There are two broad ligaments on each side of the knee to keep it stable. A blow or a twist to the knee can damage them causing swelling and tenderness which can last for a very long time. Finally, the tendons themselves, which are attached to the knee, can be inflamed either from constant wear of trauma.
Alternatively, there is a condition which affects the knee cap itself causing a degeneration often in place. This can be painful, particularly with exercise and the area is often inflamed and hot. Without examining your knee, it is impossible to say which of these is the more likely and you really do need to see your GP or attend the sports clinic at your local hospital.
Chest pain which has been around for a long time and which comes on with full inhalation is rarely, if ever, a problem with your heart. It is equally uncommon to be a problem with the lings themselves, but rather the muscles which expand and contract the ribcage. These muscles lie between and over the ribs. Unless you do a great deal of exercise which entails full expansion of your chest, forced expansion can be mildly painful. It is made worse if you suffer from any form of arthritis.
I am more concerned over your feeling of being down. Depression is poorly diagnosed and many men will go through life without realising that there are excellent treatments and help available. does not mean you will be given electro convulsive therapy (ECT). If you don't see your GP about the other two problems you most certainly should about your state of mind. You will be surprised at the reception you will get as we are increasingly aware of this problem and all GPs are keen to help.
Q . I am 16 year old, 6'4" tall, weighing 11st 5lbs, and have had an intermittent stabbing pain just below my belly button for several months. It is worse when I urinate, causing me to double up, but sometimes is not there at all. Last year I had an operation for peritonitis, but the pain is not near the scar. Any ideas? Thanks
A. This is a very difficult question to answer over the internet, and I think that the best advice would be for you to visit your GP and arrange to be referred to a urologist.
It is unlikely to be related to your previous operation.
A urologist would be able to take a detailed history of the problem and suggest possible investigations.
Page created on October 30th, 2003
Page updated on December 1st, 2009