Q I have cricked my neck. It is very stiff and hurts when I turn it. I've bought a collar which helps and am gobbling lots of painkillers. It is a bit better now but I still find it hard to look over my shoulder and occasionally I get shooting pains down my arms. I'd like to have an x-ray or scan done but my private insurance won't pay without a GP referral and he says it's not necessary, so I'm stuck. Any ideas?
A You're going to think I'm on your GP's side, whereas I promise I'm strictly neutral. It's just that x-rays are almost useless in helping people with neck pain like yours. The vast majority of neck X-rays are reported as showing "age-related changes" - the sort of wear and tear that is an inevitable part of getting older. The x-ray changes don't correlate with symptoms - people with grotty-looking necks on x-ray may have no symptoms and the nicest-looking, young neck may hurt like hell. CT and MRI scans are more trendy, expensive and detailed than x-ray but often just as useless. My advice is to throw away your collar, avoid painkillers that may upset your tummy, and see a physiotherapist, osteopath or chiropractor. If the pain in your neck or arms worsens, you may want to see a rheumatologist.
Q I am a 23-year-old man. I heard that there is a new vaccination I should be having but no one has contacted me to suggest it and I'm not sure what it is. Do you advise it?
A The government is advising all 20-24 year olds to contact their GP to have a jab against meningitis C. This vaccine is already offered to all under 18. Since its introduction in 1999 it has led to a 90% fall in cases and deaths from meningitis C. Compared to older adults, 20-24 year olds have double the risk of meningitis C. The vaccine doesn't protect against meningitis B so it is still important to be aware of signs of this terrible disease. Side-effects of the vaccine are minimal and include dizziness, headache and nausea. I'd have it done.
Q I am 35 and an unrepentant heavy smoker. I have been on the contraceptive pill for years. When I last went for a repeat prescription at a family planning clinic, I was told I couldn't have any more unless I stopped smoking. I thought this was ridiculously heavy handed. After all, it's my life and I'm prepared to take the risk. How can I get what I want - or is it really such a nanny state?
A Your health is your concern but you're asking someone else to pull the trigger for you and they have the right and responsibility not to contribute to your early demise. The WHO guidelines on contraceptive prescribing say that any woman of 35 or over who smokes more than 15 cigarettes a day is at increased risk of heart attacks and strokes and should not be prescribed a contraceptive pill containing oestrogen. If you were unlucky enough to come to any harm as a result of being on the pill, no doctor or nurse who had prescribed it would have a leg to stand on in court, even if you had signed all sorts of disclaimers. There are lots of good contraceptive options, including the mini pill which doesn't contain oestrogen.
· These answers are intended to be as accurate and full as possible, but should never be used as a substitute for visiting a doctor and seeking medical help. If you have a question for Dr Robinson, email drann@dircon.co.uk or write to her c/o The Health Editor, The Guardian, 119 Farringdon Road, London EC1R 3ER. She regrets that she cannot enter into personal correspondence.
