Dear doctor

Surgery may be best

Q My 12-year-old daughter's gym instructor mentioned that her back was rather curved and our GP confirmed that she has scoliosis. We've seen a specialist who is talking about an operation. We would rather avoid this but he implied that there is no alternative. What do you think?

A Scoliosis is when the spine takes a turn from side to side into an S or C shape. It develops most commonly in girls aged between 10 and 14, during the growth spurt of puberty. Two per cent of us have some sort of scoliosis. The usual policy is to wait and watch. If the curvature is not too bad and your daughter has nearly finished growing, she may well not need any particular treatment. She may find that an osteopath, chiropractor or physiotherapist helps to improve her posture. A brace may be recommended though kids, and some surgeons, hate them because they have to be worn 23.5 hours a day, don't necessarily work and may just delay surgery.

Surgery is reserved for the most severe cases (a curvature of over 45 degrees). Your daughter would be in hospital for 5-10 days and should gradually get back to normal over the following six weeks, although it may be six months before she can get back to gym. The problem with not having the operation now is that your daughter may well find that once she gets to the menopause, the curve suddenly worsens. She may suffer severe back pain at that stage and her heart and lung function may deteriorate which could limit her life span. After adolescence, the spine is too rigid to straighten so she won't be able to have the operation then. Speak to a specialised spinal surgeon and only let your daughter be operated on in a specialist unit. Information from

Don't worry about Depo

Q I suffer from epilepsy, and the medication that I take reduces the effectiveness of the pill. As a result I had been taking a relatively high dosage pill which was discontinued in the summer. In early June, I had a contraception injection - Depo. I started bleeding after about two weeks, and have not stopped since. I have now been bleeding for over 17 weeks. This is not simply "breakthrough" bleeding - what is causing it and what is the prognosis? My husband and I want to try for a baby - is my fertility likely to be affected?

A You're having teething problems with Depo but if you stick with it, they should improve. Depo can mess up your periods, especially after the first injection, but it does tend to settle down. You'll probably find that your periods stop altogether after four injections. It doesn't affect your long-term fertility but it can take your body up to six months to get back to normal when you stop the injections. You could go for a cap and spermicide gel or condoms, but I wouldn't rely on ovulation prediction kits (eg Persona), because the epilepsy drugs may affect the hormones in your urine.

Get comfortable at work

Q I get horrible headaches and neck pains almost every day. They tend to be on one side of my forehead and my neck feels painful and stiff. I tend to agree with my GP who thinks they are due to tension and trapped nerves. He told me to relax more and work less but I'm afraid that's not an option for me right now. Have you any other suggestions?

A Avoid painkillers which can make the headaches worse. Get advice about positioning your chair, desk and computer so that you're not straining your neck. Listen to your body which is telling you to get up from your desk, stretch, go for a walk and have a decent lunch. Osteopaths can work wonders on your type of headache and there may be one near work whom you could see in your lunch hour.

· These answers should never be used as a substitute for seeking medical help. If you have a question for Dr Robinson, email or write to her c/o The Health Editor, The Guardian, 119 Farringdon Road, London EC1R 3ER. She regrets that she cannot enter into personal correspondence.

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