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The longitudinal arch is determined by the bones, the joints, the muscles and the ligaments. Weakness in any or all of these structures may cause a flattening of the arch with or without pain.

Foot strain can develop in those who stand all day. This can be related to obesity, when the feet have to carry extra weight or to weakness of the foot.

Walking seems to develop the strength of the muscles and ligaments and doesn’t so readily lead to painful conditions. Arch supports and exercises can be of great benefit. So can losing weight.

Pain felt in the heel on walking may be due to plantar fasciitis. There is a sheet of fascia or connective tissue which runs the length of the sole and is attached to the ball of the foot at the front and to the calcaneum or heel bone at the back.

Inflammation, or even a tear, may develop where it attaches to the heel bone and may cause bone to grow out into the fascia, leading to a spur of bone projecting forward and being seen on X-ray.

The calcanean spur was once thought to be the cause of the problem and was often removed by operation. We now know it is result rather than cause.

This condition is treated by rest, by wearing a pad in the shoe to cushion the heel or by using anti-inflammatory drugs. An injection of a cortisone derivative directly into the tender area works well.

Look after your feet. If they do start to cause trouble, seek professional help early so as to minimise the problem.

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For those women who suffer attacks following infrequent intercourse, a dose of antibiotics at the time might relieve distress.

You can quickly relieve any uncomfortable symptoms by drinking plenty of water, by making up barley water or by obtaining potassium citrate in its various forms from the chemist. But you should still see your doctor and take antibiotics in the correct dose for the correct length of time to get rid of any infection.

Many women who suffer from frequency and irritation will not show evidence of infection in the bladder and, therefore, cannot be said to suffer from cystitis, although the symptoms are the same. Many of these women have been labelled as neurotic and tranquillisers prescribed.

Examination of the urethra and bladder may reveal the true diagnosis or it may rest on the history alone. They suffer from what is more correctly called the urethral syndrome.

Symptoms may be precipitated by intercourse.

This condition often responds to dilatation or stretching of the urethra — a simple procedure which can be easily done in the doctor’s rooms.

Certainly you do not have to put up with repeated discomfort, as proper treatment is available.

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Clinical trials are important to you in two ways. Firstly, results from them are used by doctors to determine which treatment is ‘best’. Secondly, you may be asked to take part in them. One of the worst aspects of clinical trials for you—the person with cancer—is that if you agree to take part in them you don’t get to decide on your own treatment (and nor, incidentally, does your doctor, because the treatment is decided by chance). You would be asked to agree to be randomised and then to have whichever treatment you are allotted by chance. Taking part in this type of clinical trial is of no benefit to you personally—you would be better off choosing the treatment you preferred (which may of course be one of the treatments being tested). It is also of little benefit to future patients because such small differences between treatments are being looked for. If people with cancer were given the choice between treatments, they would place more importance on things like convenience, side effects, comfort and time in hospital than on whether or not one or the other is likely to produce a few extra weeks or months of life. Differences in results that are big enough to be important and worthwhile for people with cancer don’t need randomised clinical trials and statistics to prove them.

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