back pain 88.
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I am a 62-year-old woman who is generally healthy, but sometimes, I suffer from aches and pains that come suddenly and then go away suddenly. Is this cause for worry? - N.M, Bat Yam
Judy Siegel-Itzkovich comments:
The March issue of the Mayo Clinic Health Letter discusses this common condition. It notes that as people get older, many suffer from aching muscles - which weaken and become less flexible - and joints. This can lead to stiffness or soreness. But in some cases, aches are a symptom of a disease or side effect of medication. You should check with a doctor when body aches have lasted more than a month, when aching is intense or interferes with normal activities, when morning stiffness lasts more than an hour or when aching has come on suddenly with no obvious cause.
Body aches can result from a variety of conditions. They include polymyalgia rheumatica, which causes widespread, moderate to severe joint stiffness and muscle aching that often involves the neck, shoulders and hips. Symptoms are usually worse in the morning. Relatively low doses of the corticosteroid prednisone usually provide remarkable relief.
In addition, short-lived body aches can accompany a bacterial or viral infection. Symptoms usually go away once the infection is gone. Rheumatoid arthritis and other forms of inflammatory arthritis are autoimmune diseases in which the immune system attacks parts of the body. These cause inflammation and tissue damage, especially in the joints. A wide variety of medications, including corticosteroids or drugs that affect the immune system, can reduce pain and inflammation. Other autoimmune diseases called inflammatory myopathies cause progressive muscle weakness over time. Corticosteroids or other drugs that affect the immune system are prescribed.
Aches and pains can also be symptoms of depression - and people coping with chronic pain often can become depressed, worsening sensations of pain and aching. Combining antidepressant medication with psychotherapy can help ease pain. In addition, possible side effects of statin drugs, commonly prescribed to reduce cholesterol, are muscle pain and weakness. Occasionally, statins may cause myopathy, characterized by severe muscle aching and weakness. To reduce pain, the patient may need to learn other ways to manage cholesterol levels.
Hypothyroid disease, which is most common in women over 60, occurs when the thyroid gland isn't producing enough of the hormone thyroxine. Symptoms include constant fatigue, muscle aches and an inability to stay warm in cooler environments. Treatment involves a synthetic version of thyroxine, usually taken in pill form. Since vitamin D deficiency can cause muscle weakness, aches and pains, vitamin D supplements can ease pain. Symptoms of fibromyalgia often include fatigue and widespread pain and aching in joints and muscles. Treatment involves a variety of pain management techniques.
I am a 25-year-old man who recently started working night shifts in a hi-tech company after previously working normal hours during the day. I have found that I eat much more and am gaining weight due to this change in schedule, and sometimes I get indigestion. What do you advise me to do?
- J.P., Herzliya
Netty Levine, a registered dietitian at Cedars-Sinai Medical Center in Los Angeles, says:
Maintaining a healthy diet can be challenging when our natural circadian rhythms - the daily activity cycles that tell our body to be awake during daylight hours and asleep when it's dark - change dramatically because of our work schedule. Some night shift workers eat at work to maintain their stamina, then go home and eat with their families. People can lose sight of portion control. Sleep deprivation is also a common problem; recent studies have shown that people who do not get sufficient sleep are more prone to being overweight. People working the night shift may drink large amounts of caffeine-rich beverages to stay awake. Then - if they are parents - they may be forced to stay awake during the day to take care of their children.
Studies have shown that ulcers are more prevalent among shift-workers than others, because the digestive system is relatively inactive at night; therefore, some foods can cause digestive problems at night yet be well tolerated if eaten during the day. Other culprits contributing to gastrointestinal problems are snack foods with a high fat content, caffeine and meals eaten in a rush or at irregular times. To prevent heartburn or indigestion, you should avoid cabbage, cucumbers, onions, high-fat or fried meals and spicy foods.
Night shift workers should exercise either before or midway through their shift to help maintain alertness and overall cardiovascular health. You can even walk through the halls if you have lots of them or on the sidewalks around your workplace. Also, bring healthful foods from home to help reduce your fat and calorie intake and also to save money and time. Eat small, regular meals with a balance of whole grain carbohydrates, protein and heart-healthy fats before 1 a.m. Choose carbohydrates that are low in fat and high in fiber like whole grain bread, fruit and low-fat dairy. Avoid caffeine at least five hours before bedtime. And when your shift is over, have a very light meal or snack before you go to bed. If you are not too full or too hungry, you'll sleep better.
Rx For Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx For Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to email@example.com, giving your initials, age and residence.
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