ASK DR ELLIE: How can I relieve the shooting hot pain in my leg?

In 2015 I had a bad fall on my left side. Weirdly, ever since I have woken up with a shooting hot pain – in my right leg – every night about 4am. I have not had a complete night’s sleep for four years. I’ve been prescribed amitriptyline and gabapentin but they don’t work. Can you help?

Symptoms that disturb sleep can be traumatising. Not only do you have to cope with the pain or discomfort, but the exhaustion that comes with broken sleep too.

Shooting and hot pain is typically nerve pain, also called neuropathic pain, caused by nerve damage, and can result from a fall or injury.

Nerves control our sense of temperature, which is why the affected area may feel hot.

Both amitriptyline and gabapentin are prescribed for neuropathic pain.

The dose of gabapentin must be increased gradually for safety reasons, so talk to your doctor about your dose as often it’s not that a medication doesn’t work, but that patients haven’t found the most effective dosage.

Amitriptyline is an antidepressant also used for neuropathic pain. It is taken at night, and doses of up to 75mg are usually effective for relieving pain and helping you sleep. A remedy called capsacin cream, available on prescription and over the counter, can also be useful if a specific area is affected.

We can’t cope with every sniff and cough 

As much as I’d love to see patients for every ache or sniffle, we simply don’t have the time (stock photo)

Health Secretary Matt Hancock last week advised the public to visit GPs for minor ailments. During a speech about the Government’s NHS forward plan, he said a hyper-vigilant approach would help patients to ‘stay healthy’. I disagree.

As much as I’d love to see patients for every ache or sniffle, we simply don’t have the time.

Pharmacists are much better suited to help.

And don’t even get me started on the fact that patients with urgent health problems are currently waiting up to three months to see their doctor due to falling GP numbers.

An electric shock machine called a TENS machine, also available from pharmacies, helps by counteracting the pain impulses from the damaged nerve.

Ask your GP about a referral to a neurologist. If the damage is correctable, surgery may be able to resolve, or at least improve, the symptoms.

I had a hip operation 12 years ago and now I read that surgery can leave scraps of metal in the bloodstream, potentially causing problems. Is this true?

In 2017, the medical authority, MHRA, recommended that hip replacement patients have regular health checks.

But this warning is only relevant if you had a type of hip replacement called a ‘metal-on-metal hip replacement’.

Only a small number of Britons had one of these – ask your GP if you did – and most of these 56,000 are fine.

The potential problems are related to the breaking down of the new hip joint – and this causes pain, swelling and difficulty walking.

There’s also damage to the joint, and microscopic metal ions can be released into the space around the hip and into the bloodstream.

Testing the level of metal ions in the blood is a useful way of seeing how much the hip has been worn down and damaged. But it does not mean there is metal in the blood stream.

It is not metal scraps they are testing for, but the ions, which are chemically different and do not cause blood poisoning.

In fact, no link between hip replacement complications and blood poisoning has been proven.

Patients who had metal-on-metal replacements should keep an eye out for chest pain, shortness of breath, fatigue or weight gain as well as changes to sight and hearing.

If you have any concerns, speak to your GP.

Fake health news is everywhere but myths about ‘cures’ for autism are among the most cruel.

So, I was disappointed to see that magazine Get Well –promoting tips to ‘reverse’ autism on the cover – was being stocked in Waitrose. Despite the misleading headlines, autism cannot be ‘cured’ or ‘reversed’.

Instead of inventing false promises preying on the vulnerable, why can’t we accept those who are different for who they are instead?