Dr Julius Parker: Back problems and picky eaters

Q. I had a car accident three years ago and have had back problems ever since. At the start of the year the pain was so intense I had to take a week off work. Gentle exercise gives me some relief but it only takes a sudden wrong move to put my back out. I’ve also been to a chiropractor but the results are only temporary. My doctor says I should consider key hole surgery but I am concerned it may cause more harm than good. What do you think?

>>In most situations a surgeon will only suggest an operation on your spine after other options have been tried. I’m not sure of the exact diagnosis in your case, but it sounds as if the road traffic accident three years ago was the trigger for your continuing problems.

Persisting pain, and on-going restriction in what you can manage at work or in your leisure time would be good indications to consider surgical treatment.

This would also be the case if physiotherapy or other treatments haven’t provided a lasting improvement, or if you need to take regular medication to control your pain.

There are several different types of surgical treatment depending on what is wrong with your back. In your situation I would recommend talking these over with an orthopaedic consultant.

This doesn’t commit you to having an operation, but it does mean you can weigh up the pros and cons with the information you need to do this.

Your surgeon will explain why an operation should help, the chances of a successful outcome, and also the risks of any procedure.

Some forms of back surgery, such as discectomy, which involves removing one or more of the spinal discs, can be relatively straightforward and recovery is usually rapid. Other procedures can be more complicated, so you do need to consider the matter carefully and it’s often helpful to talk it over with your family, as their views may help you decide.

After three years I would at least find out more about a surgical option.

Q My five-year-old son is a plain eater and mostly wants carbs — potatoes, rice and pasta. He reluctantly eats carrots and peas. Most fruits are out but he will eat chopped up apple and raisins. He has recently developed red patches under his mouth, which are spreading as he keeps licking and rubbing them. Should I be worried?

>>These red patches on your son’s face don’t sound serious but it’s important to find out what they are. I think they’re unlikely to be linked to his eating patterns. By five year old children have usually developed dietary likes and dislikes and unlike most adults they don’t seem to get bored eating the same thing most days. Providing a variety of foods and encouraging him to try different choices is best done by eating together and having the same meal as a family. You sound as if you’ve started him on several good choices already.

Red patches can be a sign of eczema, so certainly if your son had mild eczema when he was a baby, or if there’s a strong family history of eczema (or asthma) I’d consider this diagnosis. This is also more likely if there are similar patches elsewhere on his body.

Children are also prone to skin infections, which can easily spread by touching. Although eczematous patches often feel dry, an infected area may become weepy and crusted. If this is the case you should see your GP, as such infections can spread and are best treated with antibiotics. Mild eczema can often be treated effectively with moisturisers, but if your son’s red patches persist I would recommend he sees your GP for a definite diagnosis.