SAS doctor Matt Young answers your questions

Yoga, heel spurs, back pain and more!
Health
SAS doctor Matt Young is at your service.

Every month, Starts at 60 doctor Matt Young answers your health questions and offers a little advice along the way. If you have a question for Dr Young, email [email protected] or leave your question in the comments section below.

Best foot forward

Dear Dr Young, 

I have heel spurs from Plantar Fasciitis and my foot is absolutely killing me with pain! What treatments do you recommend? 

Cheers, Dana. 

Dear Dana,

Heel spurs are pretty common and they cause plenty of distress. They are little spurs of bone growing from your heel bone that cause inflammation in the fibrous tissue that runs the length of the arch of your foot. The spurs are permanent and very rarely need surgery, but the inflammation that they cause waxes and wanes. Losing weight if you a bit overweight is a good starting point. Thick socks and well cushioned shoes are a good idea, too. Inserts to put under your heel are helpful for some. Off-the-rack ones from the pharmacy are cheaper, but the ones that a podiatrist can tailor-make are probably more beneficial. Pain killers and anti-inflammatory tablets are needed in some cases and for the most severe cases I line up ultrasound-guided cortisone injections. These are easily lined up through your GP. When they are at their worst you might just have to relax, put your feet up with a red wine and watch a movie or two.

Downward dog

Dear Dr Young, 

I have never been able to get a straight answer to the following and hope that you might be able to help. Is it safe to do yoga if you have high blood pressure and take medication? I’m a bit too ancient for full headstands, so I’m mostly talking about forward folds and downward dogs. 

Many thanks, Linda.

Dear Linda,

I reckon yoga is sensational for so many medical problems. It eases the mind and keeps the body flexible. As long as you are not standing on your head and as long as the manoeuvres that you are performing are not causing dizziness, I reckon you will be good as gold doing yoga and the relaxation will only benefit your hypertension. One billion Indians can’t be wrong!

Backing up

Dear Dr Young, 

I have a problem. I was diagnosed some time ago with three bulging discs in my lower back, which prevent me from standing or walking for any length of time or distance. Six months ago, I developed sciatica and a CT scan showed that not only had the discs continued to degenerate, but I also had a compressed/narrowed nerve on the RHS. The pain is excruciating! I have been prescribed a nerve blocker, which helps for a little while but have to resort to paracetamol/codeine tablets to keep the pain at a manageable level. I don’t want to take pain killers. Is there anything else I can do to manage this pain a little better? 

Thank you, Sue.

Dear Sue,

Sciatica is certainly a very painful condition. Prevention is the best option for every disease but none more so than back pathology. All back pain benefits from weight loss if you are a bit overweight. Staying flexible is a lifelong project and things like Tai Chi, yoga and Pilates are all great for this. Good posture is essential, especially while driving and working at desks. Appropriate lifting techniques are pivotal for people who do a lot of lifting. Swimming is marvellous for maintaining the muscles that help look after your back. A good pillow and mattress are also essential.
Once things start to degenerate it is a matter of keeping the pain at bay and slowing the progression of the arthritis. Sometimes it is handy to accept that you may have some degree of pain every day and then aim to box on with your life on days when the pain is at its least. The things I have already mentioned are always relevant. Pain killers are useful for many, as are anti-inflammatory tablets and “nerve blocking” drugs, but there are plenty of simple things that might help minimise the need for these measures. Physiotherapy, regular massages, chiropractic attention, heat and rest are all helpful in many cases. CT-guided cortisone injections into the spine sound very intrusive, but are generally extremely safe and helpful for plenty of patients. Surgery is needed in a small minority of cases and represents a very large step.

Breathing break

Dear Dr Young, 

For the fourth year running now I have had a phlegmy chest. The first year I was on a Mediterranean cruise and it developed into pneumonia and pleurisy, the second year I had mild pneumonia, and last year and this year I have heavy congestion on the chest. I didn’t bother visiting the doctor with it this year, but have had it for about two months now. The phlegm seems to be lightening and I’m not waking up like I’m drowning in phlegm. Question is, is it ok just to wait it out until it clears completely? I am 66 years old. 

Cheers, Ruth.

Dear Ruth,

If you smoke, Ruth, quit. Make sure you are up-to-date with your pneumonia and flu vaccines. Stay slim and exercise. The best natural chest physiotherapy you can do for your lungs is to exercise them by walking, swimming and staying active. There are least three things that may be going on in you. You may have some degree of asthma or you may have a post-nasal drip caused by hay fever and sinus congestion. The mucus can drip down the back of your throat and into your chest, causing a cough. If you have smoked at any stage of your life you may have significant Chronic Obstructive Pulmonary Disease (COPD). All of these conditions can increase your risk of chest infections. See your GP and he may do a lung function test and perhaps a chest X-ray. Depending on the results, asthma medication or nasal sprays for hay fever or puffers for COPD may be useful. Either way, Mediterranean cruises tend to make all diseases feel better.

Do you have a question for Dr Matt Young? Email [email protected] or leave your question in the comments below! You can request to remain anonymous if you wish.

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