How to ease sciatica when painkillers won’t work – Dr Zoe Williams answers your health questions

POLLUTION can harm our health in many ways, but because it’s not immediately obvious, we tend not to worry much about it.

The effect of poor air quality on our skin, however, is one which we find hard to ignore.

Some 70 per cent of us admit to being anxious about the effects of air pollution on our complexion, with one in five people believing it is causing them to age faster.

And in the survey by Westfield’s How We Shop, more than half reported skin dryness.

It’s a good idea to check if you are in a group at higher risk of air pollution harm. This includes people with heart or lung conditions, or asthma.

Then use the Daily Air Quality Index map at uk-air.defra.gov.uk to get a pollution ‘forecast’ for your area.

On a high pollution day, for example, Defra says those at risk should reduce their physical exercise, and might need to use their inhaler more.

And people should go outside less on these days if they find it causes symptoms like a sore throat, sore eyes or cough.

Here’s a selection of what readers have asked me this week. 

Q) SINCE November I have been suffering from sciatica but I haven’t had much help from my GP.

I’ve been taking paracetamol to try to ease the pain but this is not making it much better.

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It’s reached the stage where I’ve thought of paying to see a chiropractor but they are very expensive.

Would it be worth the money?

A) I’m so sorry to hear that you’ve been struggling with this for four months.

Sciatica can be painful, but also disabling, and can affect your emotional health and your quality of life.

The majority of cases of sciatica self-resolve over six weeks.

But yours has persisted far beyond this, so I would advise seeking further support at this stage.

You may be able to self-refer to physiotherapy, or you could ask your GP to refer you to the musculoskeletal service at your local hospital. Wait times vary so, if you have the means, it may be worth seeing a private practitioner in the meantime.

It’s a shame that we don’t have access to chiropractors and osteopaths on the NHS as they are highly skilled healthcare professionals who would work brilliantly alongside our wonderful NHS physiotherapists.

Chiropractors deal with musculoskeletal issues such as those of the back, including those accompanied by sciatica.

Assuming this is what you have, and you know a chiropractor who has been recommended to you, then I’d say go for it.

If they can help, it will be money very well spent.

MYSTERY BRUISE ON MY FOOT WON’T GO AWAY

Q) FOR more than two months now I have had a problem with my foot, with a red mark that looks similar to a bruise.

I had a blood test, which has ruled out cellulitis. It sometimes feels tender. What do you think it could be?

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A) Thank you for sending the image, which shows a healing bruise over the top of your foot.

It’s great to know that there is no cellulitis, as this would need treatment with antibiotics.

There doesn’t appear to be much swelling either, which tends to be a feature of cellulitis.

Has there been an injury to this foot or is there any footwear that could have caused the bruising?

If not, then it is possible to get a stress fracture in this area of the foot.

Sometimes called a “march fracture”, it is usually caused by a sudden increase in activities, without sufficient rest, such as soldiers when they start marching.

This repetitive impact on the metatarsal bones in the foot can cause tiny fractures, which can then join to make a bigger one.

It would usually be sore during certain activities, but the pain tends to be much less than when you break a bone from a traumatic injury. I don’t know your age, but we become more susceptible to bruising with age, due to thinning skin and weaker blood vessels.

This age-related tendency towards bruising is called senile purpura and it’s thought to affect over 10 per cent of those aged over 50 years old.

Some forms of medication, for example, warfarin and clopidogrel, can make bruising more likely.

Finally, it’s important to consider that unexplained bruising on any part of your body could be a sign of an underlying disease that affects your blood or its ability to clot properly.

Vitamin deficiencies, liver disease, kidney disorders and blood cancers can all increase the likelihood of bruising.

 I’m fit and healthy but high body fat is worry

Q) I AM a 75-year-old female, with no medical problems. I do Zumba once a week and keep-fit classes three times a week.

My weight is stable but I recently tried a weighing machine at a sports centre.

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The readings showed my weight of 8st 6lb and BMI of 20.5 are fine for my height of 5ft 4in.

However, I was dismayed that my body fat is 47 per cent, which is far higher than the readings say it should be.

Should I be worried and what should I try to rectify things?

A) As you correctly say, your BMI of 20.5 is seen as a “healthy weight”, but you are right to look further as our weight is only part of what matters. Body composition matters too.

Our bodies are largely made up of water, protein, fat and minerals. Machines in the gym can estimate how much of our total weight is stored fat (47 per cent in your case), and the remainder is everything else, collectively termed “lean body mass”, which must be 53 per cent for you.

For a woman of your age, healthy body fat is seen as up to 35 per cent.

BUT these machines are not very accurate and readings can vary, even depending on how hydrated you are.

They use “bioelectrical impedance”, the metal plates you step on send electrical currents through your body.

The machine then analyses the speed at which these travel and uses that to estimate what percentage of your body weight is made up of fat.

But this really is an estimate. It’s natural for our bodies to have a higher proportion of fat as we age, and for those who are a healthy weight, this is mostly because we start to naturally lose muscle mass as early as our 30s.

I have two bits of advice for you. Firstly, as bioelectrical impedance is not all that accurate, please don’t worry.

You are clearly healthy. Zumba is fantastic cardiovascular exercise and great for putting force through the bones to prevent osteoporosis. It’s also good for the soul.

Secondly, if you want to make improvements to your body composition, please do not try to lose weight. Instead, the best approach for you would be to build additional muscle.

Doing resistance training would help you build strength. Simple exer­cises at home, such as squats, push-ups and lunges, work perfectly too.