Page 44 Daily Mail, Tuesday, July 30, 2019ONE Sunday evening 50 years
ago, as a 19-year-old, I crouched
in front of our small black-and-
white TV set to photograph the
quite incredible images of man
walking on the Moon.
This month’s celebrations of the
Moon landing brought to mind
those pictures, and also made me
think of the astonishing advances
in medical technology I’ve had the
fortune to witness.
Advances in scanning — from
ultrasounds, to CT scans and MRIs
— have revolutionised diagnosis.
Coronary artery bypass surgery
freed countless patients from the
pain of angina (one of mine was
only the 23rd in the world to
benefit), while the development
of keyhole surgery has aided
plenty more.
We saw the arrival of the first
effective drug for stomach ulcers
(cimetidine) and the first success-
ful antiviral agent (acyclovir forcold sores and shingles). We’ve
gone from sequencing the human
genome to attempting to rewrite
DNA to fight disease.
And, today, research into our gut
bacteria is opening the possibility
of new treatments for everything
from obesity to Alzheimer’s.
There’s no doubt that the doctors
of my generation, and our patients,
have lived through a golden era.
Yet we must not be complacent:
measles is back with a vengeance.
This common viral infection that
has no known treatment can cause
deafness and brain damage and
may even be fatal.
Science has given us a safe
vaccine in the form of the MMR
(measles, mumps and rubella) jab
— yet, by virtue of human nature,
‘fake news’ and misinformation,
some parents are not having their
children immunised. The vaccine is
an advance, like others, to be
celebrated, not shunned.WRITE TO DR SCURR
O WRITE to Dr Scurr at Good
Health, Daily Mail, 2 Derry
Street, London W8 5TT or
email [email protected]
— include your contact details.
Dr Scurr cannot enter into
personal correspondence.
Replies should be taken in a
general context and always
consult your own GP with any
health worries.IN MY VIEW... MMR JAB SHOULD
BE CELEBRATED, NOT SHUNNED
possible diagnosis — and it might
be that there is a combination of
both — is degenerative disease of
the lower part of the spine.
This is caused by an interplay of
osteoarthritis of the facet joints, the
buttresses that support either side
of the spine, and thinning of the
discs that act as shock absorbers in
the spine.
This degeneration could also
account for the pain and even
the trapped nerve mentioned by
the osteopath.
In exceptional circumstances,
surgery may be needed to move the
trapped nerve, but, most commonly,
the patient will be offered support-
ive care, such as physiotherapy.
It would be quite wrong — and, in
my view, unethical — to say that, at
your mother’s age, she should
merely be treated with painkillers
and rest, or even anti-inflammatory
drugs, and not investigated further.
A specialist could do a full assess-
ment, including MRI scans and
possibly a bone-density scan, to
assess any degree of osteoporosis. I
urge you to ask her GP for a referral.
Only with a precise diagnosis can
the correct treatment be applied
and plans made to restore her to
healthy function, including the
four-mile walks you say in your
longer letter she so used to enjoy.the bones, which results in them
becoming weak and fragile.
They can become so fragile that
even something as simple as
bending over or coughing can lead
to a fracture, with the hips, wrists
and spine most commonly affected.
In your mother’s case, one or
more of the vertebrae — the bones
that stack on top of each other to
form the spine — may have cracked
or crumbled.
Known as a spinal compression
fracture, this would lead to the
curvature of the spine identified
on her X-ray and could account for
the pain she is experiencing.
The foundations of osteoporosis
are laid down in teenage years and,
by the time a person is 20 or so, they
will have reached peak bone mass
and strength, when the bones are as
good as they ever can be.
Milk and other dairy products are
especially rich in the calcium needed
in adolescence to make the bones as
dense and as strong as possible. Your
mother was, however, in that age
group who grew up in years of
rationing when diet may have been
relatively impoverished.
In addition, perhaps her exposure
to sunlight may not have been
optimal (we need this to produce
vitamin D, which is essential for
calcium to be used by the body).
If she has an osteoporosis-related
fracture, your mother may be
prescribed calcium and vitamin D
supplements to take daily, to try to
prevent further injury.
She may also benefit from bisphos-
phonate, which will provide small
improvements in bone density that
make a big difference in terms of
symptoms in the future. The secondA
Q
Nothing will cure my
mother’s back pain
DR MARTIN
SCURR
ASK THE GP
MY 87-YEAR-OLD mother has had
severe lower back pain for several
months now. An osteopath arranged an
X-ray and said her spine curved in two
directions and that she had a trapped
nerve. She spent some time on treat-
ment, but is in more pain than before.
Name supplied, by email.
HOw concerning it must be to both
of you that your mother’s back hasworsened, despite her expensive
treatment. My feeling is that an exact
diagnosis would be of great value —
and that a specialist in spinal disorders
could give a more detailed assessment
than an osteopath and order more
sophisticated scans.
In someone of your mother’s age, there
are two common potential causes of her
symptoms. The first is osteoporosis, the
condition characterised by thinning ofPicture: GETTYV1