Nerves and Muscles

Can you tell me about my treatment options for relapsing remitting multiple sclerosis?

DEAR DOCTOR K: I was recently diagnosed with relapsing remitting multiple sclerosis. Can you tell me about my treatment options?

DEAR READER: Multiple sclerosis (MS) is a disabling illness that affects the brain and spinal cord and worsens over time. MS damages nerve cells and a substance that is wrapped around the nerve cells, called myelin. A nerve cell functions like a copper wire -- it transmits electrical signals. Myelin is like the insulation surrounding a wire. It helps the electrical signal get transmitted down the nerve cell. When myelin is damaged, that transmission is interrupted.

What causes peripheral neuropathy and what can I do about it?

DEAR DOCTOR K: I have peripheral neuropathy. I know that people with diabetes often get neuropathy, but I'm not diabetic. What else can cause this condition? And what can I do about it?

DEAR READER: Neuropathy is a medical term that means nerve damage. The type of nerve damage that people with diabetes get involves specific nerve fibers in all nerves, particularly the nerves that travel to the legs and feet. (There are other conditions in which a single nerve leading to the legs and feet is pinched, causing pain. An example is what is often called a "slipped disk" or "herniated disk" in the lower part of the spine).

How is an ankle-brachial index test done and what will it tell my doctor?

DEAR DOCTOR K: I had some pain in my leg while exercising, and now my doctor wants to do an ankle-brachial index test. How is it done? And what will it tell him?

DEAR READER: Atherosclerosis stiffens and clogs our arteries. It attacks the coronary arteries that provide blood to the heart muscle and causes heart attacks. It also attacks the arteries of the brain, causing strokes. Atherosclerosis also often affects the peripheral arteries of the legs. When we exercise our leg muscles, they can reach the point where we're asking them to work harder than their blood supply allows.

Beginner balance training exercises

As I discussed in a recent column, balance exercises are important for one simple reason: Poor balance can cause falls. Below are two beginner balance exercises. They are a good first step toward improving shaky balance and can be done by people of many ages and abilities, including those who are elderly or frail.

Why are balance exercises important as we age?

DEAR DOCTOR K: I'm 70 and regularly do cardiovascular and weight-training exercises. Now my doctor wants me to add balance exercises to my routine. Why?

DEAR READER: You've asked a good question, and it has a simple answer: Poor balance can cause falls. Every year, one in three adults 65 or older falls at least once. Especially in older people, falls can be serious. More than 90 percent of hip fractures result from falls. Falls also often lead to fractures of the spine, forearm, leg, ankle, pelvis, upper arm and hand. These injuries can undermine your independence. Hip fractures, in particular, also can increase the risk for early death.

Are tic disorders treatable?

DEAR DOCTOR K: My son jerks his neck constantly. Why does he have this tic? Is it dangerous? What can we do about it?

DEAR READER: Tics are upsetting -- both to the person who has them and to the people who see them. We like to feel in control of our world. A sudden, uncontrollable, rapid repetitive movement (called a motor tic) says we're not in control. Since your neck moves only when you want it to, it's disturbing to see your son doing something you know you could control. You can, but he can't.

What is costochondritis?

DEAR DOCTOR K: I'm a 38-year-old woman. I recently saw my doctor about a sharp pain that comes and goes in the middle of my chest. She assures me my heart is healthy. What could be causing my discomfort?

DEAR READER: The first thing your doctor worries about if you have chest pain is heart disease, which can be life-threatening. Fortunately, other, less serious conditions cause chest pain more often. But the first thing to be ruled out is heart disease, and it's good news that it was.

How can I loosen a frozen shoulder?

DEAR DOCTOR K: Is there any way to unfreeze a frozen shoulder?

DEAR READER: The term "frozen shoulder" describes a condition in which pain and stiffness cause a loss of the normal range of motion. Fortunately, a frozen shoulder can usually be unfrozen -- if you have the time, patience and willingness to experience a little pain.