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Ask the GP: Assist – I hear crunching noises each time I transfer my head

Q: FOR MONTHS I’ve had ear ache and once I transfer my head, I hear crunching sounds. I take ache killers 4 occasions a day for arthritis (I’m 73) however I am unable to go on like this. Are you able to assist?


A: PAIN affecting the face and head is notoriously tough to diagnose, however the truth that you additionally expertise arthritic ache in your neck and backbone leads me to consider that your cervical backbone – the vertebrae within the neck – is vital to your troublesome signs.

The crunching sounds you describe while you transfer your head are generally known as crepitus.

Joint sounds and bone cracking could be a regular a part of motion, particularly as we become older, presumably attributable to put on and tear within the joints.

In your case, these noises could also be attributable to osteoarthritis affecting the seven vertebrae within the neck – that are numbered C1 to C7 (the ‘C’ standing for cervical).

The vertebrae more likely to be inflicting your issues are C1 and C2, on the high of your backbone. C1 is situated on the base of the cranium – its position is to bear the load of the cranium. C2 ‘interlocks’ with it and permits for rotational motion, so we will flip our heads.

Whereas there are shock-absorbing discs between all different vertebrae of the backbone, there isn’t a disc in between C1 and C2.

From what you will have described in your letter, I counsel the ache in your ear and aspect of your head is because of strain on nerves of the spinal wire at that time, attributable to irritation attributable to arthritis.

A telling signal of this is able to be should you expertise some reduction by mendacity flat in your again, with a rolled pillow behind your neck. Equally, rolling your head gently to 1 aspect, as this quickly relieves strain on the nerves.

You say you will have a hospital appointment quickly, so I am hopeful that you will quickly see a spinal surgeon or a neurologist.

Q: I’VE HAD a bitter style in my mouth for months, which takes the pleasure out of consuming. I am being handled for prostate most cancers with goserelin, however my GP does not suppose that is associated. My dentist cannot discover something unsuitable with my mouth, both.


A: IT CAN BE depressing when food and drinks give no pleasure – and it is a widespread downside. The situation you describe is called dysgeusia, and it is estimated that greater than 10 per cent of us will undergo from it sooner or later, although thankfully it is often a short-lived downside.

Just lately, I had a affected person who, following a tough dental extraction, was handled for per week with two antibacterial medication, metronidazole and amoxicillin.

For the following month he skilled a bitter style in his mouth however it will definitely resolved itself, because the medicine was clearly the trigger.

Certainly, dysgeusia is often a side-effect of medicine, though in uncommon circumstances it may be an indication of vitamin or mineral deficiencies. (Simply as hardly ever, it may be an indication of an underactive thyroid, liver problems, gum illness or a mouth or throat an infection – the care of your GP and dentist counsel these should not relevant in your case.)

Relating to mineral deficiency, essentially the most generally attributed to dysgeusia is zinc – it is a downside for many who are severely malnourished or who’ve a intestine illness or continual an infection that causes malabsorption (once more, unlikely in your case, as these would have been recognized).

So again to the medicine. As many as 200 medication may cause dysgeusia. Goserelin, the drug you are being handled with, is given to decrease ranges of hormones secreted by the pituitary gland within the mind – and hormone-altering medication (together with HRT) are recognized to trigger dysgeusia.

I might counsel that these hormonal adjustments – a vital a part of your remedy – often is the trigger. I hope understanding this places your thoughts comfortable.

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