The doctor Whether its a health niggle, emotional problem or youre just looking for guidance, Inspire magazines Dr Sarah Jarvis gets straight to the point Q a year ago, i was diagnosed with arthritis in my spine, which causes a lot of pain in my back, neck and shoulders. furthermore, i have osteoporosis, scoliosis, sciatica in my right leg, spinal stenosis, lower back pain (slipped disc) and iBs. it is difficult to cope with chronic pain. ive tried all kinds of alternative treatments, as because of my iBs i cannot tolerate painkillers. someone recommended that i try the method from the margaret Hills clinic in coventry. the cure is mainly based on taking cider vinegar with honey and/or black molasses. are you familiar with this method and is it worth a try? i have to avoid eating tomatoes/acidic fruit, and eat a healthy diet with a lot of cottage cheese. maria ashley, via email Q i have been diagnosed with spinal stenosis, which is making life really miserable. i have been prescribed gabapentin tablets, but they make me very drowsy is there anything else i can do? name and address withheld do you a probl have like an em youd s so, wri wered? if inspire te to us at: magaz 275 ne wmark ine, cambr e idge cB t road, 5 or ema il inspi 8Je, arthrit iscare. re@ org.uk dr sarah Jarvis answers: Margaret Hills was diagnosed with arthritis as a young nurse in the 1940s. Having been told she would have to restrict her life drastically, and never get pregnant, she decided to look into alternative options for her arthritis. Her treatment was based on a combination of cider vinegar, black molasses, honey and an acid-free diet. She wrote a book called Treating Arthritis the Drug-free Way and later opened the margaret Hills clinic. Margaret Hills does seem to have done remarkably well in terms of her arthritis, but there is very little scientific evidence to support this approach. There have been various theories as to why cider vinegar may help. Some suggest vinegar dissolves acid crystals, which stiffen the joints; others that beta-carotene in cider vinegar destroys free radicals. But crystals are not involved in any arthritis apart from gout, and the amount of beta-carotene in cider vinegar is miniscule. As for reducing acid in the diet by avoiding citrus fruit, the Framingham study showed that people with a diet high in vitamin C from citrus fruit were less not more prone to progression of osteoarthritis. Other common myths that have no scientific basis include the belief that dairy products and nightshade vegetables, such as tomatoes and potatoes, make arthritis worse; and that sticking only to raw foods also improves arthritis symptoms. A Mediterranean diet high in vegetables and unrefined carbohydrates, such as wholegrain foods, is good for your health generally, and there is some evidence it might reduce pain in people with rheumatoid arthritis (RA). Eating a lot of red meat may make RH worse, while oily fish high in omega-3 fatty acids may help it. dr sarah Jarvis answers: Spinal stenosis is a narrowing that affects the spinal canal, down which all the nerves supplying your limbs travel. Itcommonly happens because thejoints of the spine get bigger with the ageing process; while it can affect any age group, it is more likely in older people. The part of the spinal canal most often affected is the lumbar spine. This affects the nerves supplying your legs and buttocks, so pain and numbness in these areas are common. It can also cause weakness in the legs. These symptoms settle when you rest. Your doctor should refer you for physiotherapy, to start a regular exercise routine that you can carry on yourself at home. Regular activity is key to cutting the chance of progression of your symptoms. Gabapentin was developed to treat epilepsy. Like some other medicines originally used for different parts of the nervous system, it can be very helpful for nerve pain such as spinal stenosis. Many of these medicines cause side-effects, and drowsiness is one of the most common. However, this may settle in time. Other treatment options include spinal injections, such as epidural or nerve-root blocks. If theyre successful, you may find you no longer need to take as much gabapentin. Surgery tends to be used only if other treatments have failed. The gold standard is decompression surgery, where the bone pressing on the nerves is cut away. arthritis cares helpline is staffed by qualified counsellors who can give you emotional support, and its free and confidential. call 0808 800 4050 the line is open Monday to Friday, 10am to 4pm. arthritis care also has a number of free booklets about arthritis that you can download. click here for more information.