I have a sharp pain on the left side of my torso. I thought I’d sprained something but it’s still sore a month later. What could it be?
Dr Ellie replies: Pain that lasts more than a month must always be checked by a GP as it could be a sign of cancer.
Pain in the side of the torso is most often due to a muscular strain, particularly if there has been twisting, lifting or prolonged awkward posture. This can occur during daily activities such as gardening or even sitting in the same position for too long.
Rest, anti-inflammatory tablets and avoiding strenuous activity should help – though it might take a few weeks.
Torso pain can also be triggered by shingles – the painful rash that can occur later in life when the chickenpox virus that most of us caught in childhood flares up. This can lead to a tell-tale face rash, or a burning sensation on the body, including the torso, which can be sensitive to touch.
Unfortunately, there are few effective treatments, though nerve pain drugs, such as amitriptyline and gabapentin can reduce the symptoms.
Pain in the side of the torso is most often due to a muscular strain, particularly if there has been twisting, lifting or prolonged awkward posture
However, a sharp prolonged pain in the torso might suggest a tumour in the kidneys or bowels. Typically this pain is so serious that it interferes with daily life, including sleep.
Other symptoms are unexplained weight loss, persistent bloating and nausea. In order to rule these out, it’s crucial that patients talk to their GP who, if necessary, will refer them to hospital.
I’m a 69-year-old woman and I’ve struggled with an itch on my vagina for years. My GP has been no help at all. What’s wrong with me?
Dr Ellie replies: Persistent vulval itching is most likely due to post-menopausal hormone changes.
When women go through the menopause their levels of the sex hormone oestrogen fall. This can lead to the vaginal and vulval tissue thinning and drying out. The impact of this is often intense itching, soreness and irritation. The skin may feel fragile and sensitive to touch, which can make sex uncomfortable or impossible.
Luckily, in most cases, treatment is straightforward.
Vaginal oestrogen, a form of hormone replacement therapy, available as a cream or pessary, helps restore moisture and improves tissue health. There are also specialist moisturisers that can help ease symptoms.
Another common cause is thrush, a yeast infection. This often triggers discharge, but it can sometimes cause only itching. A pharmacist should be able to provide an effective over-the-counter anti-fungal cream.
In some cases, an intimate itch may be due to lichen sclerosus – an autoimmune disease that damages the vulva.
However, vulval itching should always be checked by a GP because it can be a sign of cancer.
My husband has constant phlegm in his throat and it seems to be getting worse. What could it be?
One condition that could be to blame is post-nasal drip, when mucus from the nose and sinuses drains down the back of the throat
Dr Ellie replies: One of the most likely causes of constant phlegm is acid reflux.
The condition, also known as heartburn, is when stomach acid travels up into the oesophagus and throat, irritating the lining and triggering excess mucus production. There may be a constant need to clear the throat, mucus or a hoarse voice.
In many cases, a short trial of acid-reducing medication, such as omeprazole, can help confirm this. If the symptoms improve, reflux is likely to be the cause.
However, these tablets, also known as proton pump inhibitors, are not designed to be taken long term. Instead, lifestyle changes – such as cutting out alcohol, cigarettes, excess caffeine and fatty foods – are the best solution.
Another condition that could be to blame is post-nasal drip, when mucus from the nose and sinuses drains down the back of the throat. Saline rinses or steroid nasal sprays can reduce inflammation and mucus production.
Allergies, including hay fever or sensitivity to dust mites, can also trigger excess mucus. Over-the-counter antihistamines are often an effective treatment in these cases.
