ASK DR ZOE
From knee pain to agonising tinnitus – Dr Zoe Williams answers your health queries
Dr Zoe also helps a reader who injured their shoulder abroad
MANY studies warn of the harm that ultra-processed food poses to health.
Last week it was linked with 32 conditions, from anxiety to cancer and diabetes.
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There’s no official definition of these foods but one way to check is to see if they have more than five ingredients.
Take an apple and a chicken nugget – the former is a raw, unprocessed food, while the latter has had various chemicals added to give it texture and taste and make it last longer.
For many people, ultra-processed foods are a big part of their diet (50 per cent of calories, on average).
Of course, I’d advise trying to cut the amount of it you eat and cook from scratch more often, but I also know it can take time, money and effort to change.
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So, set easy targets such as snacking on fruit instead of crisps, then slowly tackle bigger meals.
Recipe boxes are a great way to explore healthy new foods, or follow recipe pages on social media that inspire you.
Here’s a selection of what readers asked me this week . . .
‘CERTAIN EXERCISES GOOD FOR JOINT PAIN’
Q) MY wife’s left knee gets very painful at times and she finds it very difficult to climb the stairs.
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Her doctor says that the only option is to have an operation, but at the age of 73, she doesn’t want to take the risk.
Could you please give some advice as to how to reduce the pain?
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'Saved my life' shoppers claim about joint spray perfect for any menopause symptoms and it’s slashed to £4.99 in Home Bargains
A) This sounds as though it’s most likely to be osteoarthritis of the knee given your wife’s age and the fact she finds stairs difficult.
However, there are other causes such as ligament or cartilage damage which may have been ruled out in your wife’s case?
When it comes to managing symptoms, painkillers can be very helpful to allow the person to remain active.
Exercise, which can strengthen the muscles around the knee, may seem a little counter-intuitive if a joint is painful.
However, studies have shown conclusively that improving strength can alleviate symptoms, even if you need to use painkillers.
In some areas of the UK there are exercise programmes such as Escape Pain () which are designed to help lessen pain and rehabilitate.
Studies into arthritis have found exercises that don’t put weight through the joint – like cycling and swimming – are also beneficial for pain.
There was also a cycling programme in Southampton which found that many people with knee or hip pain, who cycled, got better.
Exercise can be done at home and the NHS website has some useful videos.
Your wife could ask for a referral to a physiotherapist, too, the wait for which will depend on where you live.
Q) ON January 11, I tripped in Spain and fell awkwardly on my left shoulder.
A private clinic diagnosed a fracture of the greater tuberosity without dislocation and rupture of half of the supraspinatus tendon.
The advice was to keep it as still as possible and see my doctor when I get back to the UK.
But I’m not due back to the UK until later this month.What can I do?
I was also told to do a “coffee grinder” exercise where I let my arm hang and rotate it in a grinding motion for two minutes twice a day.
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A) Injury is never easy but it is even more challenging when you’re far from home!
The greater tuberosity of the shoulder joint is a small bump of bone at the top of your upper arm.
It is important as it is where many muscles and tendons attach to move your arm.
I can see from the X-rays you sent in that yours is broken but hasn’t moved out of its normal position.
The supraspinatus tendon connects a muscle in your upper back (the supraspinatus muscle) to the arm.
It is important for lifting your arm and rotating it inwards.
You can think of a 50 per cent rupture like a rope that has been partially frayed but is still attached.
This fracture can be very painful and initially should be immobilised in a sling, which should only be removed for personal hygiene and daily exercises.
Initially, exercises include moving the hands, wrists and elbows and gentle pendulum swings of the arm.
A repeat X-ray is usually done after a few weeks and if all is well, then more exercises are given.
Exercises like “the coffee grinder” aim to maintain some mobility in your shoulder joint without putting excess stress on the damaged structures.
Gentle movements help to prevent stiffness and promote circulation, which is important for healing.
Navigating healthcare abroad can be daunting. But, I am concerned that you’re not receiving medical support, especially as this type of injury usually causes long-term stiffness to the shoulder joint.
It may be worth inquiring about available X-ray services if you haven’t already.
If you can’t afford to see an orthopaedic specialist in Spain, at least see a physiotherapist.
Keep copies of all medical records and imaging reports to share with your home healthcare team, which helps them to pick up smoothly from your treatment in Spain.
Eat a healthy and balanced diet focusing on protein as this can help tissue repair.
Sleep and stress reduction are also very important in promoting healing.
Que te mejores pronto! (Get well soon).
Tip of the week
URINE should generally be champagne coloured.
If it is on the darker side, you are dehydrated and need to drink some water, and if there is a slight red tinge (and you haven’t eaten beetroots), this could indicate blood.
If you notice this in your pee, see your GP, even if you feel well.
Q) FOR several years I have been suffering from tinnitus. I’ve never found anything that helps.
It can be absolutely awful at times and is debilitating for me. You’d think there would be some kind of relief. Do you have any advice?
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A) Tinnitus can be an extremely debilitating symptom.
It’s when the sufferer hears sound in the absence of any actual sound from an outside source.
The sound can be anything from a ringing or buzzing to humming, hissing, whistling or throbbing.
It can be caused by age-related hearing loss, exposure to loud noises, ear disorders, head injury or Meniere’s disease – a condition that affects the inner ear.
Tinnitus can be extremely debilitating. Often, no cause is found. Sufferers deserve support
Dr Zoe Williams
Tinnitus can sometimes be a feature of anaemia, thyroid disease or diabetes.
In some cases, it can be caused by an ear infection or build-up of wax so people must see their GP initially. Often no definite cause is found.
Cognitive behavioural therapy helps improve some people’s quality of life while living with tinnitus.
There’s also specific tinnitus counselling and tinnitus retraining therapy which aims to retrain your brain to be less aware of the invasive noises.
A hearing aid might help too if you’re losing hearing quality. Some sufferers have success with acupuncture and meditation.
My main message is to validate your point of it being debilitating.
is a great resource for information and support.
In its recent survey of 478 people with tinnitus, over one in five respondents had experienced thoughts of suicide or self-harm in the last year.
So to anyone suffering from tinnitus, you deserve support.
Please note – tinnitus that comes on in only one ear and persists should always be assessed to rule out a non-cancerous tumour called an acoustic neuroma.
TOAST TO A LONGER LIFE WITH WINE
DID you know some of the best things in life can also prolong it?
According to a new study, chocolate, wine and tea can help prevent diseases.
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All are rich in flavanols, compounds found in almost all plant-based foods.
The study, published in the journal Nature, looked at the link between eating flavonols – isorhamnetin, kaempferol, myricetin, and quercetin – and the risk of death.
Researchers in the US got 11,679 participants, with an average age of 47, to submit food diaries for two 24-hour periods.
Eight years later there was a check on their medical histories.
The highest intake of dietary flavonols reduced the risk of cancer-related mortality by 55 per cent, cardiovascular disease mortality by 33 per cent, and risk of death from other causes by 36 per cent.
Rich sources of flavonols include black and green tea and dark chocolate.
However, these should be consumed alongside a healthy diet consisting of legumes (lentils, chickpeas, peas), dark leafy greens (spinach and kale), other vegetables, herbs and fruits.
The researchers also found which flavanols were beneficial for each disease.
For example, the highest myricetin consumption showed a 66 per cent drop in Alzheimer’s mortality risk.
Foods containing myricetin include red wine, fresh parsley, tomatoes, oranges, nuts and berries.
‘FIGHT MENTAL HEALTH AGEISM’
POOR mental health in older age should be taken more seriously and not normalised as part of ageing, experts warn.
The Centre for Mental Health called for older people to receive the same amount of attention and care received by younger people, who are increasingly facing mental health illness, according to statistics.
Andy Bell, chief executive at the Centre, said: “Recent reports have pointed to a deeply worrying rise in poor mental health in young people.
“We want to see similar concern for older generations so that their experiences of poor mental health are no longer dismissed as an inevitable part of ageing.”
Bell also said that ageism is “deeply entrenched and systemic, and it is causing people to miss out on a mentally healthier later life”.
He added: “This is a form of discrimination that leaves older people without effective help.”
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The report highlighted that there is no national strategy to prevent ill mental health in older age or stop it from worsening once detected.
It also suggested some immediate changes, including staff training to abolish ageist attitudes and a review of framework.
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