I’ve shrunk three inches since my teens – is arthritis to blame? Ask the GP DR MARTIN SCURR

I was recently weighed and measured at a hospital appointment – and was shocked to discover that at the age of 82 I have shrunk from 6ft 1in at school to 6ft now. I have arthritis all over. Is this to blame?

Sally Launchbury, Oxon.

This phenomenon confuses many people, but there is a simple explanation, which boils down to how the anatomy of your spine changes as you age.

There are two things going on here: First, the fibrous discs that act as shock absorbers between the vertebrae in the spine dry out and thin, a natural deterioration that cumulatively leads to inch loss over time.

A similar degenerative process affects the bone of the vertebrae. Here, microscopic changes in bone structure – accelerated in people with osteoporosis – result in the shrinking of each of the vertebrae, which also contributes to the loss of overall height.

It happens to all of us.

One study, published in the American Journal of Epidemiology, suggested that women lose more height than men (possibly due to bone loss related to menopause).

In both sexes, loss begins around age 30 and increases with age, with men between the ages of 30 and 70 losing an average of 3 cm (just over an inch), and women losing 5 cm (almost 2 inches). This increases to 5 cm for men and 8 cm for women by the age of 80.

Along with the loss of height, you may also notice that your abdomen protrudes more.

This is not necessarily because you are fatter, but because the contents of your abdomen are now compressed, as the distance between the end of your ribcage and your pelvis has been reduced.

You don’t mention what type of arthritis you have, but it seems unlikely to me that this has played a major role in your height loss – because while it can affect the facet joints in the spine, it will have little or no impact on the vertebrae and intervertebral discs.

It is the age-related changes in this that are the key to your height loss.

During a CT scan last June, a small nodule was discovered in my right lung for an unrelated problem. I’ve had it monitored, and more scans are scheduled in December. Since I have had many CT scans and x-rays over the years, I would prefer to have future monitoring done via MRI. But would this be as effective as CT scans?

Malcolm Buchan, Peterhead, Scotland.

What you describe is known as an incidentaloma – essentially a lesion discovered during examination for something else: in your case, a CT scan revealed a small nodule (which could be a growth) in your lung.

Although this had not caused any symptoms, it deserves a follow-up investigation just to be sure.

Typically, incidentalomas involve monitoring scans, perhaps every year or so. The thinking is that because imaging is non-invasive and is justified out of caution, any risks of scanning do not outweigh the benefits of early detection of a change. Obviously you are concerned about ongoing CT scans, which involve radiation exposure and the effect is cumulative.

However, according to the NHS, the amount of exposure from each scan is small, equivalent to between a few months and a few years of exposure to natural radiation from the environment.

The difference with MRI is that there is no radiation, so you avoid that potential danger.

Although I am not a radiologist, I have no doubt that most experts agree that future monitoring by MRI is appropriate and will prove no less effective in detecting any changes in the lesion.

In my opinion… we need to plan for these part-time GPs

More and more general practitioners are choosing to work part-time; a three-day working week is usual. This reflects an understandable emphasis on the importance of work-life balance, an expression unheard of in 1973, when I became a junior hospitalist.

At that time we lived in hospital, on a ‘one in two’ schedule, working every day and alternating nights and weekends, which amounted to 102 hours a week.

More and more GPs are choosing to work part-time – a three-day working week is common (Stock Image)

A year or two later, the 88-hour working week was introduced. This presented an opportunity because these new rosters meant there were more hours than people to fill them and almost every colleague worked as a locum on ‘free’ evenings and weekends. Part of the drive and energy to do this was to increase our income (two years after I started working, I was able to buy an apartment). But our extra work also reflected a commitment to our calling and a desire to gain experience.

Granted, those early days often seemed like a brutal grind with only a modest income; but we accepted this as the price we had to pay for what would come later: a better income, job security and a secure future.

I’m not sure that young GPs feel the same way. At least some of them don’t have the same sense of calling that we do.

However, the genie is out of the bottle and we cannot go back to the way things were.

But this is increasingly a reason for those in power to plan better for a future workforce that will only work part-time.

Write to Dr Scurr

Write to Dr. Scurr from Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: drmartin@dailymail.co.uk. Dr. Scurr cannot enter into personal correspondence. Answers should be taken in a general context. If you have health problems, consult your own doctor.