Asthma inhalers, Knee arthroscopy, Pelvic girdle pain, Medically unexplained symptoms

Elite athletes are far more likely to use asthma inhalers than the general population. Do the stresses and strains of competition bring on asthma-type symptoms or does an inhaler give a performance advantage to individual sportsmen and women? Dr Mark Porter talks to sports physician Dr Babette Pluim about her review of the use of inhalers in sport.

One hundred and fifty thousand knee arthroscopies are performed every year in the NHS with most of them involving surgery to smooth, remove or repair damaged cartilage, the meniscus. But there are concerns that we do too many arthroscopies in the light of evidence that intervention isn't always required. Andrew Price, Professor of Orthopaedic Surgery at the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences at the University of Oxford, tells Mark when surgery is useful and Inside Health's Dr Margaret McCartney reviews the mounting body of evidence that has called into question some knee surgery. Dr Annabel Bentley, former Medical Director of Insurance at the private health insurers, BUPA, describes how, back in 2011, there was an instant (and subsequently sustained) reduction of 9% in knee arthroscopy claims. The drop came weeks before a new checking process, to confirm the surgery was in line with best practice, was introduced.

Pelvic Girdle Pain is a condition that affects one in five pregnant women. It causes discomfort in the pubic region, the hips and lower back and gets worse as the pregnancy progresses. Some cases can be mild but more severe forms can leave a woman needing crutches, or even a wheelchair, to get around. But there is help out there and official advice is for women to get help early and not to suffer in silence. Mark visits the Rosie Maternity Hospital in Cambridge, and speaks to new mum Joanna Welham and Women's and Men's Health Physiotherapist, Claire Brown, about what treatment is available.

Medically unexplained symptoms, sometimes known as MUS, cause problems for both patient and doctor, and they're common, up to a fifth of a GP's workload, and around half of all specialist referrals, costing the NHS more than £3 billion a year. Rona Moss Morris is Professor of Psychology as Applied to Medicine at King's College London and she believes the NHS fails such patients. She tells Mark what she thinks needs to change, starting with the name, MUS.

Producer: Fiona Hill.