Pain that still bowls me over (From Bradford Telegraph and Argus)

Pain that still bowls me over

9:21am Tuesday 28th October 2008 in Questions & Answers By Dr Tom Smith

Q: A year ago, after a day of crown green bowling on a wet and heavy green, I woke the next morning with a pain in my neck and weakness in my left arm and leg. I had to have an operation for a disc problem in my neck, since when I haven’t yet got back to my previous mobility. I still get pain in my arm. Will I ever get back to my normal fitness? I’m over 80.

A: It sounds as if the operation was done to prevent you becoming much worse – even to prevent you from becoming paralysed. It has been a success in doing that, but it has left you with inevitable nerve damage. It may recover a little, but you have to face the possibility that this is the best you can be. Talk to our doctor about the continuing pain in your arm. There may be ways of dealing with that, including painkillers, stretching exercises organised by your physiotherapist, and even injections.

Q: You wrote about statins lately and said how important they were. I’m not so sure. I have had muscle pains with them, and so have at least two friends. My doctor switched me to ezetimibe, and that works well. Its only side effect is an occasional headache, but I can tolerate that. Why don’t doctors prescribe it more? Is it just cost?

A: Because statins work well for the vast majority of people. We are well aware of the muscle side effect, and change treatments accordingly, and we keep ezetimibe for people who really can’t tolerate statins. It isn’t just cost that dictates the choice. Some people can’t tolerate ezetimibe, so we prescribe accordingly, but it’s true that ezetimibe costs the NHS more than £20 for 28 days, and most statins are now around £1-£2 for the same time. Imagine the huge extra cost if all the millions of people on statins were changed to ezetimibe, for very little in the way of health advantage?

Q: Since I have been taking tablets for my blood pressure I have had pains in my muscles, in my back and legs. I’m also short of breath. Could these be side-effects of the drug?

A: It’s difficult to say, as you don’t mention the name of the drug. However, it is too easy to blame new symptoms on a drug: there are all sorts of possible causes of muscle pains and breathlessness that are not linked to drug treatment, and today’s range of drugs to lower blood pressure are remarkably free from side-effects. So tell your doctor about these pains and particularly about the breathlessness. You may need tests to find out the cause. Don’t try to treat yourself and definitely do not stop the blood pressure treatment.