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Answers to questions about knee pain, altitude sickness, and food allergies.

Q What might be causing pain in the back of my knee?

A Posterior knee pain can result from a number of issues, such as injury to one or more muscles and tendons that connect to the back of the knee: the biceps femoris tendon (a hamstring tendon); the popliteus muscle/tendon, which rotates the shin bone (tibia); and the gastrocnemius tendon, which connects the calf muscle to the back of the knee.

Other potential causes of pain in the back of the knee include a baker's cyst, a buildup of synovial fluid that forms a sac behind the knee; an injury to the posterior cruciate ligament, which stabilizes the back of the knee; and a torn meniscus, one of the crescent shaped pieces of cartilage in the knee.

In general, these injuries can be treated with rest, ice, compression, elevating the injured leg, and over-the-counter analgesic/ anti-inflammatory medications. Surgery may be necessary for more severe injuries.

Keep in mind that pain behind the knee also may be a sign of deep vein thrombosis, a blood clot in a leg vein that can travel to the lung and cause a life-threatening pulmonary embolism. If your posterior knee pain is accompanied by pain, swelling or redness in your calf muscle, seek help immediately.

Q I'm planning a climbing trip. How can I prevent high-altitude sickness?

As you climb higher, you have less oxygen available to breathe, raising the risk of acute mountain sickness and the more serious high-altitude cerebral and pulmonary edema.

One way to limit your risk of these conditions is to avoid traveling directly to altitudes above 8,000 feet in a short time. Rather, ascend gradually and give your body a few days to acclimatize to the thinner air. Avoid over-exertion above 8,000 feet, rest frequently, drink plenty of non-alcoholic fluids, and sleep at an altitude of about 1,500 feet lower than where you spend your waking hours. If possible, carry oxygen with you.

Symptoms of high-altitude sickness include dizziness, shortness of breath, headache, nausea, fatigue, rapid heart rate, and cough. In more severe cases, changes in complexion, chest tightness, decreased consciousness and problems with motor function may occur. If you notice any symptoms, move to a lower altitude as quickly and safely as possible.

Talk to your doctor about medications such as acetazolamide (Diamox[R]), which can lessen the time it takes your body to acclimatize to the high altitude. Also, if you have a chronic medical condition, such as congestive heart failure, ask your physician if you can travel safely to high elevations.

Q How can I tell if I have a food allergy? Should I be tested?

A The best way is to see an allergist to determine if you have a food allergy--an immune system reaction that can cause potentially life-threatening symptoms, sometimes affecting multiple organ systems--or a food intolerance, a non-allergic abnormal response to a particular food that is usually less serious and limited to the digestive system.

The allergist will ask about your medical history, the foods you eat, and the nature of your symptoms. You'll undergo tests to see how you react to allergy-causing foods (allergens). Also, the doctor may suggest a food challenge, in which you're given a placebo or a potential food allergen to identify a cause of your symptoms. Common food allergens include milk, eggs, fish and shellfish, peanuts, soy products, tree nuts, and wheat.

Keep a food journal and document your symptoms to help your allergist. If you have a food allergy, avoid the problem food, check food labels carefully, and ask about the ingredients in the meals you order at restaurants.

Editor-in-Chief Richard S. Lang, M.D., M.PH., EA.C.P.

Vice Chairman, Cleveland Clinic Wellness Institute
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Title Annotation:ASK DR. LANG
Author:Lang, Richard S.
Publication:Men's Health Advisor
Date:Nov 1, 2016
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