Why do I hear cracking noises every time I move my head? DR MARTIN SCURR answers your health questions

I have had ear pain for months and when I move my head I hear cracking noises. I take painkillers for arthritis four times a day (I’m 73) but I can’t go on like this. can you help

Marie France, Liverpool.

Facial and headaches are notoriously difficult to diagnose, but the fact that you also have arthritic pain in your neck and spine leads me to believe that your cervical spine – the vertebrae in your neck – is the key to your troubling symptoms.

The cracking sounds you describe when you move your head are called crepitations.

Joint noise and bone cracking can be a normal part of movement, especially with age, possibly due to wear and tear on the joints.

In your case, these sounds may be due to osteoarthritis affecting the seven vertebrae in your neck, numbered C1 through C7 (the “C” stands for cervical).

The vertebrae most likely causing your problems are C1 and C2 at the top of your spine. C1 is located at the base of the skull – its job is to support the weight of the skull. C2 “clips” to it and allows a rotary motion, allowing us to turn our head.

While there are shock-absorbing discs between all other vertebrae of the spine, there is no disc between C1 and C2.

From what you described in your letter, I suggest that the pain in your ear and the side of your head is due to pressure on the nerves of the spinal cord at that point, caused by inflammation from arthritis.

A telltale sign of this would be if you feel some relief from lying flat on your back with a pillow rolled around your neck. Similarly, gently roll your head to one side as this will temporarily relieve pressure on the nerves.

You say you have a hospital appointment next year, so I hope you see a spine surgeon or a neurologist soon.

For months I have had a bitter taste in my mouth that takes the fun out of eating. I am being treated with goserelin for prostate cancer but my GP doesn’t think it is related. My dentist can’t find anything about my mouth either.

Barry Chamberlain, by email.

It can be miserable if food and drink are not tasty – and this is a common problem. The condition you describe is known as dysgeusia, and it’s estimated that more than 10 percent of us will suffer from it at some point, although thankfully it’s usually a short-term problem.

I recently had a patient treated with two antibacterial drugs, metronidazole and amoxicillin, for a week after a difficult tooth extraction. The next month he experienced a bitter taste in his mouth, but it eventually went away on its own as the medication was clearly the culprit.

Dysgeusia is usually a side effect of medication, although in rare cases it can be a sign of a vitamin or mineral deficiency.

(Just as rarely, it can be a sign of an underactive thyroid, liver disease, gum disease or an infection of the mouth or throat – concerns from your GP and dentist suggest that this may not be the case in your case.)

It can be miserable if food and drink are not tasty – and this is a common problem

When it comes to mineral deficiencies, zinc is most commonly attributed to dysgeusia – a problem for those who are severely malnourished or have an intestinal disease or chronic infection that causes malabsorption (again, unlikely in your case as they would have noted). .

So back to the drugs. Up to 200 drugs can cause dysgeusia. Goserelin, the drug you are being treated with, is given to lower levels of hormones secreted by the pituitary gland in the brain – and hormone-altering drugs (including hrt) are known to cause taste disturbances.

I would suspect that these hormonal changes – an integral part of your treatment – could be to blame. I hope knowing this puts your mind at ease.

Write to Dr. scramble

Write to Dr. Scurr to Good Health, Daily Mail, 9 Derry Street, London W8 5HY or email: drmartin@dailymail.co.uk — add contact details. DR Scurr cannot respond to personal correspondence. Answers should be taken in a general context. If you have health problems, contact your GP.

In my opinion: bureaucracy hinders the care of our patients

According to a recent study commissioned by the British Medical Association, most general practitioners and more than half of hospital doctors believe the gap between primary care and hospital care is harmful to patients.

It has also been found that a major cause of this is the bureaucratic obstacles that prevent remittances.

When I first joined the practice in 1974, I only had to send a letter to refer a patient for a specialist consultation – the patient would then receive an appointment card in the post.

There was nothing wrong with that system, but it was gradually eroded, first by the advent of the single market – a cost-cutting strategy which meant that patients could only be referred to services contracted by the GP – and an explosion of bureaucracy.

Today, GPs usually have no idea who their patient sees after a referral. Worse, they have to track it down when patients haven’t heard from patients for weeks and it’s inevitable that some conditions will worsen in the meantime.

We need a radical rethink to remove the administrative barriers that hinder patient care: bureaucratic rigidity is not more important than immediate care for those affected by illness and tragedy.

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