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Carpel tunnel case keeps getting worse




 

 

DEAR DR. ROACH: I had surgery on my right wrist for carpal tunnel syndrome eight months ago. The numbness in my fingers has not changed. Now I’m faced with the same problem in my left hand. I’m going to forget surgery, seeing as it wasn’t successful in my right hand.

I decided to go to an acupuncturist for laser treatments. I also had a cortisone shot. Neither of these has helped. Do you know of a solution for my problem? — P.M.

ANSWER: Carpal tunnel syndrome is caused by compression on the median nerve, as it runs down the arm through a “tunnel” of bone and connective tissue deep in the wrist. It may cause pain, numbness and weakness of the wrist and hand. The thumb and middle three fingers are most often affected. In advanced cases, the hand muscles may become atrophied. The sooner the pressure on the nerve is relieved, the more likely there will not be permanent nerve damage.

It sounds to me like the first surgery was not done soon enough to prevent damage. If that’s the case, then surgery on your left hand, done sooner after the onset of symptoms, might prevent the longterm numbness present in your right hand. However, it’s possible that the diagnosis was wrong or that the surgery might not have been effective, even if done promptly.

At least one study of needle acupuncture showed that it is as effective as a cortisone injection. This study excluded people who already had fixed numbness in the fingers, who are less likely to be helped by any treatment. I have not found any evidence that laser treatment is effective.

My advice is to first be sure of the diagnosis. An EMG test is a study of nerve function, which can confirm the diagnosis and may be able to predict how much damage there is and provide guidance on treatment. If damage is not too severe, other treatments — such as splinting, medication, yoga or ultrasound — may be helpful. If advanced, surgery done quickly still may be your best bet.

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DEAR DR. ROACH: There has been much reporting of the effect of not getting enough sun during the winter months. In your professional opinion, can some people get depressed from too much summer?

When I lived in the Southwest, all that heat and sun from May to October seemed to really get to me. I wished often for a cloudy day. Is it because I was raised in the depressing North? — J.R.W.

ANSWER: Seasonal affective disorder is a type of major depression with recurrent seasonal onset and remission. Although it usually is described as beginning in late fall and early winter, and going away in spring or summer, some people can have symptoms that begin in spring and go away in fall. People with spring- onset SAD more frequently have insomnia, poor appetite and weight loss.

Light therapy is used only for fall-onset SAD. Both medication and psychotherapy, especially cognitive behavioral therapy, are used for spring-onset SAD.

I don’t know whether being brought up in the North predisposes one to the spring-onset form of SAD. I don’t find the North particularly depressing.

Readers may emai l questions to ToYourGood- Health@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to P.O. Box 536475, Orlando, FL 32853-6475.

©2015 North America Synd.


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