Dr Tom Smith 

Doctor, doctor: Migraines and arthritis

Will headaches caused by strip lighting stop me studying? Plus how should I handle the pain in my thumb? Dr Tom Smith has the answers
  
  

migraine
Univeversity challenge: Will a bad reaction to strip lighting stop a new student studying? Photograph: PR

I am in my 40s and am starting a master's course. However, I suffer from migraines triggered by fluorescent strip lights, which are everywhere at the university, and I am concerned that they will ruin my ability to study. My GP suggests a preventive drug treatment, but I'm uneasy about that. Could filtered coloured lenses help?
Your doctor should be able to put you in contact with a migraine specialist in your area, or with the Migraine Trust and/or the City of London Migraine Clinic. If the consultant thinks you need particular lenses, then you should be able to get help from the NHS, but this would not be in the remit of your GP alone. As for being given daily medication to prevent your developing migraines, I would agree with your GP: most people who take it find it life-changing, and with few, if any, adverse effects. There's no harm in starting it in the meantime, so that you can begin your studies with confidence.

I have developed arthritis in my right thumb – I am right-handed, female and 71. One physiotherapist I saw gave me a Velcro cuff to keep the thumb supported; another told me to exercise it, which seems rather contradictory advice. I was also told to take paracetamol, which I don't want to do as I am already on pills for high blood pressure and high cholesterol. Any ideas?
If only that thumb and no other joint is affected, then the problem would seem to be the result of an injury or overuse. It might even be a sign of gout. You don't mention whether you have been to see a doctor – new arthritis in a single joint at any age needs to be checked up on. So please see your GP, who will want to make a more specific diagnosis and may want to investigate further, perhaps with an x-ray and blood tests. If it does turn out to be arthritis, then paracetamol, which is a painkiller but not a very good anti-inflammatory, may not be the ideal drug for you. Your doctor will advise you on the best way to deal with the pain.

• Got a question for Dr Tom? Email doctordoctor@theguardian.com

 

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