This is extremely common. Pain caused by sudden movement is best treated with simple painkillers, by keeping mobile, and by taking care to sit upright with a support for the small of your back. If no cause is known or the pain continues for more than one week or gets progressively worse, seek medical advice.

Apply generous quantities of cold water to the affected area as soon as possible and maintain this until the pain subsides. This may take as long as 15 minutes. If the skin is unbroken but blistered, apply a loose, dry dressing. If the burn is larger than four or five inches in diameter or if the skin is broken, consult your doctor or casualty unit as soon as possible.

Although debilitating, these are viral illnesses which are usually self limiting. Although antibiotics do not help in viral illnesses, paracetamol, aspirin or Ibuprofen can relieve the symptoms. Make sure you drink plenty of fluids, keep warm and have lots of rest.

If you are concerned that your condition is worsening after several days, or you develop symptoms such as a cough with green phlegm, you may be developing a complication. Seek medical advice.

Most sore throats and earaches are viruses and respond to painkillers taken over two to three days. If symptoms persist, or you or your child are becoming increasingly unwell despite the treatment, seek medical advice.

Most stomach aches are not serious and are caused by indigestion or wind. Simple painkillers, a hot water bottle or, in the case of indigestion, a teaspoon of bicarbonate of soda in half a glass of water may settle things. If symptoms persist or worsen, do seek medical help. Stomach aches with associated diarrhoea and vomiting suggest gastroenteritis. Because the lining of the stomach is likely to be inflamed, medicines are frequently vomited.

Plenty of light fluids (water, squashes, thin soup or rehydration solutions available from chemists) should be taken to counter the liquid you lose with diarrhoea or vomiting. Babies and small children are most at risk of dehydration, so if symptoms persist, especially if they start to pass urine infrequently, medical advice should be sought.

Many babies have loose bowel actions during the early months of life due to their mainly liquid diet. Sudden bouts of more watery diarrhoea, should be treated by increased fluids, but if symptoms persist, especially if accompanied by vomiting or lethargy, seek medical advice.

Treat with a cold compress, containing ice if possible, for 15 to 30 minutes to reduce the swelling. Firmly apply a crepe bandage and give the sprain plenty of rest until all the discomfort has subsided. Further strain will inevitably lead to further swelling and a longer recovery period. The word RICE is a useful way of remembering the main ways to treat sprains; Rest, Ice, Compression (with an elasticated support) and Elevation (with a sling or a footstool)

Sit in a chair, lean forward with your mouth open and pinch your nose just below the bone for approximately ten minutes, by which time the bleeding should have stopped. Avoid hot drinks or hot food for 24 hours. If symptoms persist, consult your doctor.

Wash the wound thoroughly with water and a little soap. To stop bleeding, apply a clean handkerchief or dressing firmly to the wound for about five minutes. Cover with a clean, dry dressing.

Treat as for other burns with cold water to remove the heat. Calamine lotion will relieve the irritation whilst paracetamol will also help. Children are particularly susceptible to sunburn and great care should be taken to avoid overexposure to the harmful effects of the sun by liberal use of high factor sunscreen, sunhats etc.

Antihistamine tablets and creams can be obtained from the chemist without prescription and will usually relieve most symptoms.

Note: bee stings should be scraped away rather than 'plucked' in order to avoid squeezing the contents of the venom sac into the wound.

Head Lice

Contrary to popular belief, head lice prefer clean hair and are therefore not a sign of poor personal hygiene. They appear frequently in school and nursery aged children due to the close physical contact between this age group. First line treatment is to repeatedly comb wet hair after the application of plenty of hair conditioner (makes the hair more slippery), with a plastic head louse detector comb. The combs can be bought from most chemists, and must be checked regularly for bent teeth. This must be done regularly in case of new eggs hatching and re-infection.

Second line treatment involves lotions with insecticide which can be obtained from the chemist without prescription. Ask your chemist which preparation is best for you, as some asthmatics cannot tolerate the alcohol based preparations. Only treat those found to be infected and inform any school, nursery or friends who have been in recent contact.

This presents as a rash starting as small red patches about 3-4mm across. Within a few hours these develop into small blisters, and further blisters form over the next few days. The patient frequently feels better once the rash appears having felt miserable for a couple of days preceding the onset of the blisters .

The most infectious period is from two to three days before the rash appears until after the last blister has dried. Chickenpox is usually a mild condition in children, but adults can be quite unwell from the virus. Avoid contact with pregnant women unless they are sure they have previously been infected with chickenpox. Even if a pregnant woman gets chickenpox the risk to the unborn baby is not great. However, a non-immune pregnant woman should be vaccinated if she has been in contact with the disease, so if there is any doubt about immunity, speak to your doctor.

Feeling low or sad is common especially if precipitated by an event in your life. If the symptoms persist beyond two weeks, and are associated with poor sleep, waking early in the morning, reduced memory and concentration, alteration of appetite, lack of energy or enjoyment, you could be suffering from depression. Please consult your doctor to discuss it further.

Coughs

The commonest cause of a cough in an otherwise healthy person is a viral infection of the upper airways. There are a number of treatments which are available from the pharmacist, although many of these may offer little in the way of relief. Unfortunately, the majority of such illnesses do not respond to antibiotics. If you start developing a high fever, shortness of breath or if your cough lasts for more than 4 weeks, consult your doctor. Asthmatics and those people with other chest or heart conditions may need to see their doctor sooner.

Warts

Warts and verrucae are caused by a family of viruses. They are very common and most people will have a wart at some time during their lifetime. They are harmless and usually disappear within a year or two without treatment. However, some warts and verrucae can become painful or irritating. They can be treated with liquids from the pharmacist or with liquid nitrogen which we can apply at the surgery. Ask your doctor for more details.

Acute Sinusitis

This can be caused by a virus, a bacteria, or even an allergy. The main symptoms are rather like those of a cold, with additional pain in the facial bones above and below the eyes and offensive nasal discharge. Sometimes it can be difficult to distinguish between viral and bacterial sinusitis. Usually steam inhalations with Vicks help, together with anti-inflammatories (such as ibuprofen) and paracetamol based medication. Sometimes antibiotics are required, particularly if there is a high fever or extreme pain.

Urine Infections 

The commonest symptoms of a urine infection include burning or stinging when you pass water and frequently needing to empty your bladder. You may notice that your urine is usually strong or smelly. If you are female, and if these are your only symptoms they may settle down on their own within a day or two. Increasing your fluid intake and drinking cranberry juice helps, and there are some medications available from the pharmacist for cystitis. Men, children and pregnant women should consult the doctor if they develop symptoms of a urine infection. Anyone who develops a high fever or loin pain needs to see the doctor. 

Haemorrhoids

Haemorrhoids, or "piles", are enlarged veins around to opening of the anus (back passage). They are very common, particularly in pregnant women and in those people who are prone to constipation. They are usually harmless, although they can be quite itchy and uncomfortable. They often show themselves by the presence of blood on the toilet paper, and very occasionally they can bleed quite heavily. The main treatment is to make sure you drink plenty of water and make sure that you do not become constipated by eating adequate fibre-rich foods such as fruit, vegetables, bran and wholemeal bread. If you notice blood mixed in with your stools, or if you feel generally unwell or are noticing an unexplained loss of weight, consult your doctor.

MMR

The MMR vaccination has been the subject of much controversy over recent months. Despite media reports, there is no reliable medical evidence of any link to autism or inflammatory bowel disease. We still strongly recommend that you immunise your children against these potentially serious diseases

Assessing your Sick Child

Childhood illness is inevitable and an essential part of developing a healthy immune system. Most bouts of illness pass quickly and leave children better able to resist the next attack. Sometimes it can seem as if your child always has a cold or upper respiratory tract infection. This is because there are many different viruses which cause symptoms of snotty nose, sore throat and occasional fever. Unfortunately antibiotics do not usually cure these types of illnesses. Paracetamol and ibuprofen are both helpful in reducing temperatures, are available without prescription, and they can be given in combination if necessary (asthmatics should avoid ibuprofen). Keep the room well ventilated, and make sure your child drinks plenty of fluids. Vicks vapour rub or similar products can help clear the airways, as can a steamy bathroom.

Everyone is worried about the possibility of meningitis and septicaemia in their children. Thankfully these are rare conditions, but they are also very serious, and anyone who has any of the following symptoms or signs should seek medical advice as soon as possible:

>a rash which does not disappear when a glass is pressed firmly against it.

>pain on looking at the lights, or inability to cope with daylight, particularly if associated with a fever.

>stiffness of the neck, especially when accompanied by fever. Try asking your child to kiss their knee. See if this triggers complaints of a stiff or painful neck.

Babies under six months of age can be difficult to assess. They often will not show as many signs of serious illness as an older child. Look out for undue drowsiness, cold or clammy hands and feet, pale or bluish skin colour, refusal to feed, and prolonged screaming or crying where he or she is inconsolable. No-one knows your baby better than you, and if you think that something is "not right", you should ring the surgery.

The following symptoms and signs are potentially serious and you should contact your doctor straight away:

>a fit, or if your child turns blue or very pale, or seems floppy

>a temperature over 39^oC, especially if there is a rash

>difficulty breathing, or grunting in a baby

>unusually drowsy, listlessness, hard to wake or confusion

>refusing feeds, urination infrequent, dry mouth or sunken eyes

Meningitis is rare, but presents in its early stages like most cold or flu viruses. However, it progresses rapidly to symptoms of severe headache, vomiting, drowsiness and dislike of bright lights. In small children it can present as an irritable, drowsy child, feeding poorly.

A distinct rash may appear as the disease progresses, which will not seem to disappear if the bottom of a clear glass is pressed on the rash.

Urgent and immediate attention is essential.

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