r Flo,
My work involves standing for long hours during the day and this has not had a problem until recently. I have been experiencing a lot of pain from the knee to the toes. The pain becomes severe when I continue standing and I have had to take painkillers and apply an ointment in order to sleep. What could be the problem?
My work involves standing for long hours during the day and this has not had a problem until recently. I have been experiencing a lot of pain from the knee to the toes. The pain becomes severe when I continue standing and I have had to take painkillers and apply an ointment in order to sleep. What could be the problem?
Peter
Dear Peter,
Most of the time, leg pain comes from continuous use or wear and tear of the muscles, ligaments, tendons, joints or bones. We use our legs every day, for those of us lucky enough to have functioning legs, and at some point, the hardware begins to wear out. This is especially true for those who walk or stand a lot.
Other causes of pain in the legs may be problems with the spine or the lower back, arthritis, inflammatory diseases, blood clot, circulation disorders, nerve disorders, infection, cancer, injury, gout, problems with calcium levels and even muscle cramps from dehydration.
It would be advisable for you to visit a doctor because you need a proper examination for the pain and weakness. You also need some tests to establish the exact cause of the pain, so that you can get specific treatment. You can manage the pain by using painkillers and massaging with analgesic ointments. Also, try and rest your legs as much as possible, raise your legs when you are sitting or lying down, and apply an ice pack to the area that is most painful. Depending on the cause of the problem, physical therapy/physiotherapy may be helpful, as well as regular exercise. Wear comfortable shoes and take adequate water to avoid muscle cramps caused by dehydration.
Other causes of pain in the legs may be problems with the spine or the lower back, arthritis, inflammatory diseases, blood clot, circulation disorders, nerve disorders, infection, cancer, injury, gout, problems with calcium levels and even muscle cramps from dehydration.
It would be advisable for you to visit a doctor because you need a proper examination for the pain and weakness. You also need some tests to establish the exact cause of the pain, so that you can get specific treatment. You can manage the pain by using painkillers and massaging with analgesic ointments. Also, try and rest your legs as much as possible, raise your legs when you are sitting or lying down, and apply an ice pack to the area that is most painful. Depending on the cause of the problem, physical therapy/physiotherapy may be helpful, as well as regular exercise. Wear comfortable shoes and take adequate water to avoid muscle cramps caused by dehydration.
Dr Flo,
I have had chest pain since 2010. I have received treatment from various hospitals without improvement. What or where should I visit?
Julius
Dear Julius,
It would be advisable for you to be seen by an internal medicine specialist/physician, so that the exact cause of the pain is identified, then you can be referred to a sub-specialist if need be. The chest has many components including the heart, the lungs and pleura (lining of the lung), a part of the oesophagus, muscle, bones, cartilage, nerves and blood vessels.
The heart — some of the symptoms of a heart problem include chest pain and heaviness, palpitations, difficulty breathing, running out of breath or getting tired easily, and coughing. Tests can be done to identify if there is a heart problem.
The lungs and the pleura — inflammation of the lung and/or pleura may be caused by infection or by irritants like chemicals and dust. An infection will cause significant pain, cough, fast breathing or difficulty in breathing and fever. If an infection is present, symptoms usually worsen over time if there is no treatment and the symptoms do not disappear on their own. Inflammation caused by irritants and cold, however, may come and go depending on exposure. Avoiding the trigger will prevent the pain. Some medication can also be prescribed to manage the symptoms.
The oesophagus — in its journey between the mouth and the stomach, the oesophagus passes through the chest. Sometimes, problems with the oesophagus can present as chest pain. These include oesophagitis (inflammation of the oesophagus), hyperacidity and reflux and oesophageal strictures caused by scarring of the lining of the oesophagus. In addition to the chest pain, you might also have heart burn, discomfort or pain when swallowing food, nausea and/or vomiting, and other gastrointestinal problems. If you have these symptoms, it would be advisable to have an endoscopy done by a gastroenterologist (stomach specialist), to determine the cause, and you will be started on treatment.
The muscles — in between the ribs, there are actually three layers of muscles, known as the intercostal muscles, there are also many other muscles on the front and back of the chest and along the spine. Any of these muscles could ache, what is called myalgia (muscle pain), either due to recurrent strain, repetitive activity or even from muscle cramps. Usually after some rest, this pain goes away on its own, or you may require painkillers and muscle relaxants.
The nerves — there are many nerves running within and across the chest wall. Any of them could get “trapped” or damaged, leading to chest pain. This is usually much more difficult to diagnose, but the treatment is medications for pain, and usually the pain goes away with time. If a number of nerves are involved, however, an MRI may need to be done to determine the exact source of the problem for appropriate intervention.
The bones (and cartilage) — there is cartilage that connects the ribs and the sternum (the breast bone). In some cases, there is inflammation between the cartilage and the bone (either the ribs or the sternum). This is called costochondritis, and the resultant pain may feel as though the heart has a problem. The pain is usually on the left side of the chest, and it may be sharp, or aching, or feel like pressure. The pain is usually worse when you take a deep breath, when you cough or with physical activity, and it usually affects more than one rib. It usually has no clear cause, though it may be triggered by injury, or physical strain, or arthritis. Less likely causes include infection or tumours in the joint. Treatment includes pain medication, physiotherapy with stretching and nerve stimulation exercises (TENS), hot or cold compresses and rest. Usually the pain improves on its own after several days or weeks, but sometimes will recur after several months.
The heart — some of the symptoms of a heart problem include chest pain and heaviness, palpitations, difficulty breathing, running out of breath or getting tired easily, and coughing. Tests can be done to identify if there is a heart problem.
The lungs and the pleura — inflammation of the lung and/or pleura may be caused by infection or by irritants like chemicals and dust. An infection will cause significant pain, cough, fast breathing or difficulty in breathing and fever. If an infection is present, symptoms usually worsen over time if there is no treatment and the symptoms do not disappear on their own. Inflammation caused by irritants and cold, however, may come and go depending on exposure. Avoiding the trigger will prevent the pain. Some medication can also be prescribed to manage the symptoms.
The oesophagus — in its journey between the mouth and the stomach, the oesophagus passes through the chest. Sometimes, problems with the oesophagus can present as chest pain. These include oesophagitis (inflammation of the oesophagus), hyperacidity and reflux and oesophageal strictures caused by scarring of the lining of the oesophagus. In addition to the chest pain, you might also have heart burn, discomfort or pain when swallowing food, nausea and/or vomiting, and other gastrointestinal problems. If you have these symptoms, it would be advisable to have an endoscopy done by a gastroenterologist (stomach specialist), to determine the cause, and you will be started on treatment.
The muscles — in between the ribs, there are actually three layers of muscles, known as the intercostal muscles, there are also many other muscles on the front and back of the chest and along the spine. Any of these muscles could ache, what is called myalgia (muscle pain), either due to recurrent strain, repetitive activity or even from muscle cramps. Usually after some rest, this pain goes away on its own, or you may require painkillers and muscle relaxants.
The nerves — there are many nerves running within and across the chest wall. Any of them could get “trapped” or damaged, leading to chest pain. This is usually much more difficult to diagnose, but the treatment is medications for pain, and usually the pain goes away with time. If a number of nerves are involved, however, an MRI may need to be done to determine the exact source of the problem for appropriate intervention.
The bones (and cartilage) — there is cartilage that connects the ribs and the sternum (the breast bone). In some cases, there is inflammation between the cartilage and the bone (either the ribs or the sternum). This is called costochondritis, and the resultant pain may feel as though the heart has a problem. The pain is usually on the left side of the chest, and it may be sharp, or aching, or feel like pressure. The pain is usually worse when you take a deep breath, when you cough or with physical activity, and it usually affects more than one rib. It usually has no clear cause, though it may be triggered by injury, or physical strain, or arthritis. Less likely causes include infection or tumours in the joint. Treatment includes pain medication, physiotherapy with stretching and nerve stimulation exercises (TENS), hot or cold compresses and rest. Usually the pain improves on its own after several days or weeks, but sometimes will recur after several months.
Dr Flo,
How can I stop secreting milk after an abortion?
W C
Dear W C,
After an abortion, milk let down will gradually decrease and end since there is no breastfeeding. If the milk production is causing your breasts to swell and become painful, you can use warm or cold compresses or take a hot bath. Avoid stimulating the nipples or expressing the milk since this will increase milk production. However, if the milk is a lot or it lasts for long, a doctor can prescribe medication to stop production and to relieve pain from engorged breasts.