My leg cramps are so bad it brings me to tears – is my medication to blame?

THE NHS is always in need of more blood donors. Think it’s too much of an inconvenience? It’s easier than ever to give blood these days, with thousands of sites around the country. Sun columnist Dr Zoe answers your burning health queries Credit: Olivia West One reader is suffering from cramp in their leg Credit: Getty When booking your one-hour appointment online, you can filter it by date and location to suit your schedule. NHS Blood and Transplant says the summer has affected stock as there is more demand from hospitals for blood. Sign up for the Health newsletter Thank you! But fewer people are eligible to donate in hot weather, due to a drop in iron levels, and dehydration. And then there are holidays and childcare, which can put some people off attending. Visit my.blood.co.uk/sign-up to book in and donate. Q: I AM a 69-year-old man and a few years ago suffered thigh cramps so severe they would bring me to tears. They sometimes took 20 minutes to go. My GP switched my statin to pravastatin – I also take cande-sartan and amlodipine – and the cramps went. But recently, after lots of walking for work, they’ve returned and the after-effects can last days. My thighs can feel bruised, heavy and uncomfortable. Most read in Health Could this be due to my medication or age? A: I’m sorry you’re experiencing this. Severe cramps can be incredibly painful. It may be related to overuse, especially as it has flared up after lots of walking. A strong cramp can leave the muscle sore for a few days, almost like a strain. But because this has been severe enough to bring you to tears, and affects your walking after, it deserves review. Medication is one possibility. Statins can cause muscle aches, cramps or weakness. The fact that your symptoms improved after changing to pravastatin is relevant, but it does not prove the statin is definitely the cause. Don’t stop taking it without medical advice, but ask your GP if a medication review and blood tests are needed, such as for kidney and liver function, thyroid function, calcium, magnesium, potassium, vitamin D and a CK blood test, which can show muscle irritation or injury. Other causes to consider include dehydration, salt loss after sweating, circulation problems, nerve irritation from the back or muscle fatigue from doing more than usual. Pain brought on by walking and relieved by rest can sometimes suggest reduced blood flow to the legs, so your GP may want to check the pulses in your feet. In the meantime, build activity up gradually and stretch out the calves and thighs gently. Consider if you are hydrating well and getting enough salt, especially on very active or hot days. When cramp hits, gently lengthening the affected muscle may help, but don’t force it. Seek urgent help if you develop severe swelling, redness, weakness, dark urine, chest pain, breathlessness or one leg becomes much more painful or swollen than the other. It hurts him to walk Q: MY husband used to be so busy, doing DIY and playing golf, but now he just wants to sit and watch TV because walking is so painful. We are unsure if the two are connected, but after about a year of rituximab treatment for Non-Hodgkin lymphoma, he developed peripheral neuropathy. It has really affected his life because it is painful to walk. He coped really well with the treatment for his lymphoma and it helped tremendously. But we are at a loss when it comes to easing the pain when he walks. He wears pressure socks and has tried insoles, but nothing seems to make a difference. When he has no weight on his feet, they are fine. I read your page regularly so wondered if you could help. A: I’m sorry your husband is going through this, though it’s wonderful that the rituximab has helped his lymphoma. Foot pain feels life-changing, because it can take away independence, hobbies and confidence very quickly. Peripheral neuropathy means irritation or damage to nerves outside the brain and spinal cord. Some cancer treatments can cause neuropathy – and although rituximab is not strongly associated, that doesn’t mean it is impossible. The fact his feet are fine with no weight on them is important. Pain mainly on standing or walking can also come from mechanical foot problems such as plantar fasciitis, arthritis, tendon issues, meta-tarsalgia, thinning of the natural fat pads or poor circulation. He should tell his haematology or oncology team because new nerve-type symptoms during lymphoma treatment deserve review. Sometimes lymphoma itself, immune changes, diabetes, vitamin B12 deficiency, thyroid problems, alcohol, kidney function or other medication can contribute. I would ask for an assessment of his feet, pulse, gait, sensation and footwear. A podiatrist or physiotherapist may also be able to help, especially if the pain is mechanical rather than nerve-based. Possible blood tests include B12, folate, thyroid, diabetes check, kidney function and inflammatory markers. If neuropathy is confirmed, there are medicines aimed at nerve pain, but they work best when the diagnosis is clear. Seek urgent advice if he develops rapidly worsening weakness, loss of bladder or bowel control, spreading numbness, foot ulcers, or a cold, pale or blue foot. Health tip TAI CHI can help with several conditions that plague many people, including arthritis, back or neck pain, fibromyalgia and osteopenia, research shows. This traditional Chinese exercise is great to practise in mid-life and beyond – go online to find a group class near you. Where has dizziness come from? Close up of senior woman (80s) with headache Credit: Getty Q: FOR over 20 years, I’ve been on daily doses of amlodipine and ­simvastatin. But for a few weeks, I have been feeling quite dizzy and unsteady on my feet. A recent CT scan came back normal, as did my blood pressure. I had a stay in hospital 16 years ago with a severe attack of labyrinthitis. Could this be related? I am an 82-year-old woman. A: I’m sorry you feel like this. Dizziness and unsteadiness can be very unsettling. Your normal CT scan and blood pressure are reassuring, but they do not rule out every cause of dizziness. A CT scan can exclude some serious problems, but many causes of dizziness come from the inner ear, medication effects, heart-rhythm changes, balance systems, vision, dehydration anaemia or nerve changes in the feet and legs. Your history of labyrinthitis is relevant. A severe inner-ear infection can leave people more prone to episodes of vertigo, imbalance or feeling “strange-headed”. Another common inner-ear cause is BPPV, where tiny crystals in the balance organ move into the wrong place, causing dizziness with movement. This can often be treated with repositioning manoeuvres. Amlodipine can sometimes contribute to light-headedness or ankle swelling, and blood pressure can drop on standing even if a seated reading looks normal. Simva-statin is less likely to cause dizziness directly, but any medication should be reviewed when new symptoms appear. I would ask your GP to check your lying and standing blood pressure, pulse, ears, eye movements, gait and balance. Blood tests for anaemia, thyroid, kidney function, salts, glucose and B12 may also be useful. Fall-prevention matters, too. Use supportive shoes, avoid rushing and consider a walking aid temporarily if needed. Seek urgent help if you develop new weakness, facial drooping, slurred speech, chest pain, fainting, severe headache, new hearing loss or sudden worsening. Comment now