ACHES AND PAINS

Back pain affects between 60-80% of the population at some stage in their lives. It is estimated to account for 14 million Primary Care consultations annually, with an overall cost to the NHS of £600,000,000.000 per year. 95% of back pain does clear completely within 3 months although with a significant recurrance rate.

Most back pain is caused by over use, unaccustomed use or poor posture, often at work. Paracetamol plus reduced activity for a few days is usually quite effective.

Much could be prevented by sitting and standing upright and maintaining a modest level of physical activity, eg walking 10 to 20 minutes daily.

Most back pain improves within 2 or 3 days with rest and Paracetamol. Activity should then be resumed. Consult your doctor if pain persists beyond this time or is going down the leg. Patient education is important - ask your GP for a computer generated information leaflet.

Difficulty in controlling bladder or bowels in association with low back pain demands IMMEDIATE medical advice.

STRAINS AND SPRAINS

Usually caused by injuries which result in damage to ligaments which support joints or to muscles. REST - the obvious first choice. ICE - application of an ice-pack, eg a packet of frozen peas wrapped in a dish or towel for 10 - 30 minutes to reduce swelling. COMPRESSION - crepe bandage firmly applied. ELEVATION - limits further swelling. Gentle activity can usually be resumed in 48 hours - if not, consult your doctor.

BURNS AND SCALDS

Apply large amounts of cold water until the pain subsides - often 10 - 15 minutes. If the skin is blistered, apply dry loose dressings and giVe Paracetamol if necessary.

If the skin is broken or the area involved is more than 5" in diameter - go to hospital immediately.

SUNBURN

Can be treated along similar lines. Calamine lotion is often soothing in addition to Paracetamol. Fluid intake should be increased.

Children are particularly susceptible to sunburn - avoid over-exposure, use plenty of sun block and don't forget the broad-rimmed hat.

CUTS AND GRAZES

Wash with soap and water. Apply clean handkerchief or dressing firmly to control any bleeding. Cover with a clean dry dressing.

If wound is contaminated, extensive or bleeding uncontrolled - go to hospital.

INSECT BITES AND STINGS

Antihistimine tablets/syrup obtained from the chemist without a prescription usually relieves local irritation.

If the lip or tongue becomes swollen, especially if breathing is affected, go to hospital immediately.

NOSE BLEEDS

Sit upright - preferably over the sink or bowl - and pinch your nose just below the bone for 10 minutes - a long time in this situation!

If two attempts are unsuccessful, go to the Walk-in Centre or hospital.

Once bleeding stops, avoid nose blowing or hot food/drinks for 24 hours.

COUGHS, COLDS AND SORE THROATS

Mostly caused by viruses, infections which resolve spontaneously in a few days. Rest, fluids and Paracetamol usually relieve aches and fever. Antibiotics are usually not necessary.

Children often develop high temperatures which can be alarming. Remove excess clothing, give Paracetamol and encourage unlimited fluids. Cool sponging is often soothing.

DIARRHOEA

Usually due to food-born organisms and resolving spontaneously in 24 to 48 hours. Vomiting often initially. Symptoms eased by avoiding solid food, taking frequent small volumes of fluid containing glucose. Antidiarrhoeal capsules, eg Immodium, can be obtained from the chemist without a prescription. Consult your doctor if not improving in 48 hours.

Young children and babies need close attention since they cannot withstand fluid loss as well as adults and older children. Feeds should be restricted to boiled water for the first 24 hours with Dioralyte or Rehydrat which can be obtained from the chemist without a prescription. Consult your doctor if the condition lasts for more than 24 hours, is accompanied by vomiting ans especially if your child becomes lethargic.

SKIN RASHES

Common - often as a reaction to environmental agents such as food or household materials. Sometimes members of the family show similar tendency. Antihistimine creams/tablets can be obtained from the chemist without a prescription. These usually soothe any irritation. Contact the surgery for an appointment if rash persists more than 24 to 48 hours.

Children often develop transient skin rashes in response to viral infections. Some specific infections cause rashes - see later. If the child is otherwise well, give fluids and Paracetamol if necessary and contact the surgery for an appointment.

NB If the rash is spreading rapidly; if the child/adult is unwell; if the lips and tongue are swollen; if there is any difficulty with breathing...

**GO TO HOSPITAL IMMEDIATELY**