My neck has been very stiff and painful for three years. Every aspect of my life is affected, including my sleep and mental health. I’ve had physio, seen an osteopath and tried hydrotherapy, but nothing has helped. What else can I try?

Andy Poole, by email.

Dr Martin Scurr replies: The cervical spine – your neck – is a remarkably intricate and fragile structure, which does a lot of heavy lifting (literally), supporting and moving your head, which weighs on average 5kg, and protecting the nerves in your spinal cord.

The bones in the spine, known as vertebrae, are separated by shock-absorbing discs. Over the years, this cushioning wears away, which can lead to inflammation – this is likely to be the cause of the stiffness and pain you are experiencing.

While degeneration of the spinal discs is part of ageing, you’re in your early-60s (as your longer letter explains), which is on the young side for this.

You say the stiffness set in about two months after you had heart bypass surgery – it is possible that the position of your body on the operating table, combined with two or three months of inactivity while you recovered, somehow triggered problems in the facet joints, which buttress the vertebrae on either side of the spine.

These joints help support the spine but also allow it to flex and twist. It could be that they are now compressing on nerves, causing the pain and stiffness.

I suggest asking your GP for a referral to a spinal specialist or neurosurgeon, with the idea of having an injection of a local anaesthetic and corticosteroid into the facet joints (done under the guidance of an X-ray).

The cervical spine – your neck – is a remarkably intricate and fragile structure, which does a lot of heavy lifting (literally), supporting and moving your head, which weighs on average 5kg

The local anaesthetic eases pain in the short term and the corticosteroid, which kicks in a few days later, can provide many months of pain relief. The steroid will also help with the stiffness, by easing the swelling and inflammation.

At this point you could restart physiotherapy, to regain full movement. I would avoid osteopathy as in my view it can be too vigorous and in this area could potentially be harmful.

These injections don’t work in all cases but when they do, they can make a considerable difference.

I discovered I had a 16mm meningioma during a scan for an ear problem. I’ve been advised to have another MRI in a year to see if it has grown. Is this the best advice? I know Davina McCall had her brain tumour removed.

Name and address withheld.

Dr Scurr replies: Your tumour, like Davina McCall’s, is benign, meaning that it is a non-cancerous lump that grows slowly and won’t spread to other parts of the body.

One of the most common types of brain tumour, meningiomas develop in the meninges – the membranes that surround the brain and spinal cord.

They don’t usually cause symptoms but some people do develop seizures, weakness of a limb, changes in hearing or vision, depending on where the growth is.

TV presenter Davina McCall had surgery last year to remove a brain tumour which was benign, meaning it was a non-cancerous lump

The treatment depends upon a number of factors, with the size, rate of growth, the location, as well as your age and state of health all coming into play.

If the meningioma is small – up to 3cm in size – and there are no symptoms, then the usual approach is what we call ‘active surveillance’ – this means repeating a scan periodically, usually annually, and only if the meningioma grows further will treatment be recommended.

Treatment includes surgery, radiotherapy, or a combination. It is to be hoped that once you are under observation, no further action will ever be needed.

If there’s no change after three to five years then the scans are carried out less often, and eventually surveillance is stopped after ten years.

In my view... Could tackling stress help cancer patients?

It’s long been suggested that mood or emotion have an influence over what happens when we are ill – even aiding recovery.

I first became interested in this when I observed that young people would experience their worst ever hay fever during the weeks of their A-level or degree exams, suggesting that stress had an effect on their immune systems.

And now research is emerging to show that this link is far from ‘woo-woo’, starting with the relationship between stress and cancer. We now know that stress has an impact on the growth and spread of cancer cells.

One new approach is looking to see if blocking certain ‘stimulating’ chemicals such as adrenaline with medication (e.g. beta blockers) improves outcomes in different types of cancer.

There is little doubt that countering stress is going to be no less important than continuing to develop new drugs for chemotherapy.

One pillar of effective cancer treatment currently is enhancing our own immune systems, i.e. immunotherapy – and understanding the relationship between the brain and our immune function will be part of that.