A to Z of Medical Conditions

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Otosclerosis – signs and symptoms of Otosclerosis

Otosclerosis

Otosclerosis

Otosclerosis is a condition in which there’s abnormal bone growth inside the ear. It’s a fairly common cause of hearing loss in young adults.

There are three tiny bones deep inside the ear, which vibrate when sound waves enter. They transmit sound waves to the cochlea (inner ear), which converts them into signals that are sent to the brain.

In otosclerosis, the stapes (“stirrup” bone) begins to fuse with the surrounding bone, eventually becoming fixed so it can’t move. This means sound is no longer transmitted into the inner ear efficiently.

 

Symptoms of otosclerosis

Most people with otosclerosis notice hearing problems in their 20s or 30s. One or both ears can be affected.

Symptoms of otosclerosis include:

hearing loss that gets gradually worse over time

particular difficulty hearing low, deep sounds and whispers

speaking quietly because your voice sounds loud to you

finding it easier to hear when there’s background noise (unlike many other types of hearing loss)

tinnitus (hearing sounds such as buzzing or humming that come from inside your body)

dizziness – though this is rare

The symptoms of otosclerosis can be hard to tell apart from other causes of hearing loss.

Is otosclerosis serious?

Otosclerosis can cause mild to severe hearing loss, but it very rarely causes total deafness.

Your hearing usually gets worse gradually over months or a few years and may continue to get worse if ignored and left untreated.

However, the hearing loss can normally be treated successfully with either hearing aids or surgery (read about treatments below). Hearing is improved or restored in around 80-90% of people who have surgery.

Very occasionally, otosclerosis can spread to the inner ear, resulting in a greater level of hearing loss that can’t be improved with surgery.

When to get medical advice

See your GP if you’re worried about your hearing.

They will ask about your symptoms, examine your ears, take your medical history and may do some simple hearing tests.

If your GP suspects a problem such as otosclerosis, you’ll be referred to an ear, nose and throat (ENT) specialist or an audiologist (hearing specialist) at a nearby hospital.

The specialist will carry out some further hearing tests and possibly a scan of your head to help identify the problem.

Treatments for otosclerosis

Otosclerosis can usually be treated successfully with either a hearing aid or surgery. If your hearing loss is very mild, you may not need any treatment at first.

Hearing aids

A hearing aid is an electronic device that increases the volume of sound entering your ear so you can hear things more clearly.

The advantage of using a hearing aid is that, unlike surgery, it doesn’t carry any risks. Modern hearing aids are small and discreet, and some can be worn inside your ear so they’re not obvious.

You can talk to an audiologist about the different types of hearing aid available and which may be best for you.

Surgery

Surgery is an option if you would prefer not to wear a hearing aid. The main operation used is called a stapedotomy or stapedectomy.

The operation can be done under either general anaesthetic (you’re asleep) or local anaesthetic (you’re awake but your ear is numbed). A cut is made inside your ear canal, or occasionally above or in front of your ear, to access the bones inside your ear.

Part of the stapes bone is removed and a plastic or metal implant is put into the ear to transmit sound from the remaining bones into the inner ear. You’ll be able to go home the same day or the day after.

This is a delicate operation that’s usually very successful. But as with all operations, it carries a small risk of complications, including:

losing more or all of your hearing (in about 1 in 100 cases)

altered sense of taste (usually temporary)

new or worsened tinnitus

vertigo (usually temporary)

facial weakness (very rare)

You can discuss the risks and benefits of both surgery and hearing aids with your surgeon to help you decide which you would prefer.

Causes of otosclerosis

The exact cause of otosclerosis is unclear and it’s not known whether you can do anything to prevent it.

Many cases seem to run in families and it’s thought they may be the result of inheriting a faulty gene from a parent.

The condition can occasionally get worse more quickly during pregnancy, which may mean changes in hormone levels sometimes play a role.

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Plantar fasciitis – symptoms and treatments

Plantar fasciitis

Plantar fasciitis

Heel Pain

Heel pain is a common foot condition. It’s usually felt as an intense pain when using the affected heel.

Heel pain usually builds up gradually and gets worse over time. The pain is often severe and occurs when you place weight on your heel.

In most cases, only one heel is affected, although estimates suggest that around a third of people have pain in both heels.

The pain is usually worse first thing in the morning, or when you first take a step after a period of inactivity. Walking usually improves the pain, but it often gets worse again after walking or standing for a long time.

Some people may limp or develop an abnormal walking style as they try to avoid placing weight on the affected heel.

What causes heel pain?

Most cases of heel pain are caused when a band of tissue in the foot, known as the plantar fascia, becomes damaged and thickens.

Plantar fasciitis is the medical term for the thickening of the plantar fascia.

The plantar fascia

The plantar fascia is a tough and flexible band of tissue that runs under the sole of the foot. It connects the heel bone with the bones of the foot, and acts as a kind of shock absorber to the foot.

Sudden damage, or damage that occurs over many months or years, can cause tiny tears (microtears) to develop inside the tissue of the plantar fascia. This can cause the plantar fascia to thicken, resulting in heel pain.

The surrounding tissue and the heel bone can also sometimes become inflamed.

Read more about the causes of heel pain.

When to see your GP

See your GP or a podiatrist (foot problems specialist) if you’ve had persistent heel pain for a number of weeks and it hasn’t cleared up.

They should be able to diagnose the cause of your heel pain by asking about your symptoms and medical history and examining your heel and foot.

Further tests will only usually be needed if you have additional symptoms that suggest the cause of your heel pain isn’t inflammation, such as:

numbness or a tingling sensation in your foot, which could be a sign of nerve damage in your feet and legs (peripheral neuropathy)

your foot feels hot and you have a high temperature (fever) of 38°C (100.4°F) or above, which could be a sign of a bone infection

your heel is stiff and swollen, which could be a sign of arthritis

Possible further tests that may be recommended include blood tests, X-rays, a magnetic resonance imaging (MRI) scan or an ultrasound scan.

Who gets heel pain?

Heel pain is a common foot condition. An estimated one in 10 people will have at least one episode of heel pain at some point in their life.

People who run or jog regularly, and older adults who are 40-60 years of age, are the two main groups affected by heel pain.

Treating heel pain

There are a number of treatments that can help relieve heel pain and speed up your recovery. These include:

resting your heel – avoiding walking long distances and standing for long periods

regular stretching – stretching your calf muscles and plantar fascia

pain relief – using an icepack on the affected heel and taking painkillers, such as non-steroidal anti-inflammatory drugs (NSAIDs)

wearing well fitted shoes that support and cushion your feet – running shoes are particularly useful

using supportive devices – such as orthoses (rigid supports that are put inside the shoe) or strapping

Around four out of five cases of heel pain resolve within a year. However, having heel pain for this length of time can often be frustrating and painful.

In about one in 20 cases, the above treatments aren’t enough and surgery may be needed to release the plantar fascia.

Read more about treating heel pain.

Preventing heel pain

Being overweight can place excess pressure and strain on your feet, particularly on your heels. Losing weight and maintaining a healthy weight by combining regular exercise with a healthy, balanced diet can be beneficial for your feet.

Wearing appropriate footwear is also important. Ideally, you should wear shoes with a low to moderate heel that supports and cushions your arches and heels. Avoid wearing shoes without heels.

Read more about preventing heel pain.

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Pericarditis- what you need to know

Pericarditis

Pericarditis

Symptoms of pericarditis

The most common symptom of all types of pericarditis is chest pain.

Most people who have had pericarditis describe experiencing a sudden sharp pain, usually behind their breastbone, on the left side of their body. Some people describe the pain as more like a dull ache or feeling of pressure.

The pain may also radiate up from your chest into your left shoulder and neck.

It’s usually worse when breathing in, coughing, eating and lying down. Sitting up or leaning forward will usually help relieve the pain.

When to seek medical advice

Always seek immediate medical advice if you experience sudden chest pain chest pain. While most cases of pericarditis are not serious, it’s important that other more serious conditions are ruled out, such as a heart attack or a blood clot.

 

Additional symptoms

Depending on the underlying cause of your pericarditis, you may also experience:

a high temperature (fever)

shortness of breath

fatigue

nausea

dry cough

swelling of the legs or abdomen

In some cases, pericarditis occurs along with myocarditis, which is inflammation of the heart muscle.

If these symptoms only occur for a short time or a one-off episode, it’s called “acute pericarditis”. However, if they last three months or more, it’s known as “chronic pericarditis”.

Read about the complications of pericarditis for more information.

Recurring pericarditis

Recurring pericarditis is when you experience frequent episodes of pericarditis.

There are two main types of recurring pericarditis:

Incessant pericarditis – symptoms develop once medications such as non-steroidal anti-inflammatory drugs (NSAIDs) are withdrawn. Symptoms usually begin within six weeks of the treatment being withdrawn.

Intermittent pericarditis – there are long periods without any symptoms (often many months or sometimes years) before symptoms return without warning.

It’s estimated that one in four people with a history of acute pericarditis will develop recurring pericarditis.

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Cystic fibrosis – the signs and symptoms to look out for

Cystic fibrosis

Cystic fibrosis

Cystic fibrosis can cause a range of problems. The lungs and digestive system are the main areas that are affected.

Symptoms tend to start in early childhood, but sometimes they can develop soon after birth and very occasionally they may not be obvious until adulthood.

Nowadays, cystic fibrosis is usually diagnosed before symptoms appear, through screening tests carried out soon after birth. Read more about screening for cystic fibrosis.

The main problems associated with cystic fibrosis are outlined below.

Lung problems

Cystic fibrosis can cause sticky mucus to clog the lungs and airways. This can cause:

recurring chest infections – these occur because mucus in the lungs is an ideal breeding ground for bacteria

persistent inflammation of the airways, which can cause them to become abnormally widened (bronchiectasis)

increased coughing

occasional wheezing and shortness of breath

Over time, the lungs can become increasingly damaged and may eventually stop working properly.

Digestive system problems

The mucus can also block parts of the digestive system, which can affect how food travels through the gut and how it’s broken down or absorbed.

This can cause:

a serious bowel obstruction in the first few days of life (meconium ileus) – this will often need an operation to remove the blockage

jaundice

diarrhoea or large, smelly stools

problems putting on weight and growing – this can occur because the body struggles to digest and absorb nutrients (malnutrition)

diabetes from late childhood or early adulthood – this can develop if the pancreas becomes severely damaged

Other problems

People with cystic fibrosis can also experience a number of other problems, including:

sinusitis

nasal polyps

thin, weakened bones (osteoporosis) – this can occur as a result of repeated infections, poor growth, lack of physical activity and malnutrition

swelling and pain in the joints (arthritis or arthralgia) from late childhood

difficulty conceiving children – most men with cystic fibrosis are unable to have children naturally (although some fertility treatments may still work) because the tubes that carry sperm don’t develop correctly; women can become pregnant, however

liver problems caused by the tiny bile ducts in the liver becoming blocked by mucus

leaking of small amounts of urine, particularly during coughing fits (stress incontinence)

 

Enzyme
Enzymes are proteins that speed up and control chemical reactions, such as digestion, in the body.
Liver
The liver is the largest organ in the body. Its main jobs are to secrete bile (to help digestion), detoxify the blood and change food into energy.
Faeces
Stool (also known as faeces) is the solid waste matter that is passed from the body as a bowel movement.
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Bursitis – find out more and watch this great video

Bursitis

Bursitis

Bursitis is inflammation and swelling of a bursa. A bursa is a fluid-filled sac which forms under the skin, usually over the joints, and acts as a cushion between the tendons and bones.

The main symptoms of bursitis are pain, swelling and tenderness in the affected area.

Any bursa can become inflamed, but bursitis most commonly occurs in the:

shoulder

elbow

knee (known as housemaid’s knee)

hip

Other areas affected can include the ankle, foot and Achilles tendon (the large tendon that attaches the heel bone to the calf muscle).

What causes bursitis?

A bursa can become inflamed through injury or repetitive movement.

Your risk of developing bursitis is increased if you regularly take part in physical activities that involve a lot of repetitive movement, for example running (bursitis in the ankle) or playing darts (bursitis in the elbow).

People who spend a lot of time kneeling, such as carpet fitters and gardeners, also have an increased risk of developing bursitis in their knee.

Less commonly, bursitis can develop as a result of an infection or as a complication of certain conditions, such as gout or rheumatoid arthritis.

Read more about the causes of bursitis.

Treating bursitis

Most cases of bursitis can be treated at home. Resting the affected area, using an ice pack (a frozen bag of vegetables wrapped in a tea towel works well) to reduce inflammation, and taking painkillers such as aspirin, paracetamol and ibuprofenwill help relieve your symptoms and speed up your recovery.

The pain usually improves within a few weeks, but the swelling may take longer to completely disappear.

See your GP if your symptoms do not improve after two weeks.

Read more about treating bursitis.

Preventing bursitis

Taking precautions, such as wearing knee pads when kneeling and warming up properly before exercise, may help reduce your risk of getting bursitis.

Read more about preventing bursitis.