U.S. doctors online nowAsk doctors free

Doctor Q&A for Dr. Jeremy Bland

A 35-year-old female asked:
Dr. Jeremy Bland
Neuromuscular Medicine 40 years experience
Get a diagnosis: The first question here has to be what it is. Common causes of hand pain are carpal tunnel syndrome (CTS), tenosynovitis, and various forms of arthritis, all of which require different approaches to treatment. You have not given enough information for a guess at diagnosis to be possible. You can check out how likely it is to be CTS at least by doing the questionnaire at www.carpal-tunnel.net
A 28-year-old female asked:
Dr. Jeremy Bland
Neuromuscular Medicine 40 years experience
Probably a tic: If it's always in the same place and rhythmic then a tic is the most likely explanation. Not usually serious.
1 thank
A 27-year-old female asked:
Dr. Jeremy Bland
Neuromuscular Medicine 40 years experience
-ve EMG is OK: EMG/NCS have quite a significant false negative rate for ulnar neuropathy at the elbow so the diagnosis remains possible but it could be argued that if there is no measurable nerve damage and no wasting or weakness now, it would be reasonable to try less aggressive measures first. Conservatively treated cases seem to do more or less as well as surgically treated ones overall.
A 33-year-old male asked:
Dr. Jeremy Bland
Neuromuscular Medicine 40 years experience
Nerve disease: It't just a technical generic term for any disease affecting the nerves outside the brain and spinal cord. Peripheral neuropathy can be of many different distributions and has thousands of possible causes.
A 25-year-old member asked:
Dr. Jeremy Bland
Neuromuscular Medicine 40 years experience
Unknown: Three interestingly definite answers from my colleagues there. I know of no scientific studies of the question so the real answer is that we don't know. Did you have a particular instrument in mind? Instruments that can be played with a straight wrist will be less likely to aggravate CTS on theoretical grounds.
A 31-year-old member asked:
Dr. Jeremy Bland
Neuromuscular Medicine 40 years experience
Not much: The only oral drug that has been clearly shown to benefit CTS in randomised trials is prednisolone. You are not going to get that over the counter and wouldn't want the side effects. NSAID's, diuretics, gabapentin - all no better than placebo in trials. Amitriptyline, pregabalin - no trials to judge by. Rest and a splint is the best self-help tactic
A 28-year-old female asked:
Dr. Jeremy Bland
Neuromuscular Medicine 40 years experience
See a doctor: This illustrates well that, although textbooks tell you that CTS improves after delivery of the baby in 'most' cases, 'most' is not all, and in fact persistent symptoms are commoner than is generally thought. If it's still there after a month then it is quite likely to require treatment with splint, injection, surgery, depending on what has been tried already. Splints you can get for yourself.
A 32-year-old member asked:
Dr. Jeremy Bland
Neuromuscular Medicine 40 years experience
No: 'RSI' is not a true diagnosis but a portmanteau term for any problem thought to be due to over-use of a limb. It covers a wide variety of real diagnoses with different treatments so whenever anyone tells you you have 'RSI' the first question you ask should be "OK but what is the diagnosis?"
A 38-year-old member asked:
Dr. Jeremy Bland
Neuromuscular Medicine 40 years experience
No: CTS is less common in people who type all day than in manual workers, suggesting that typing is not a major risk factor for CTS
A 29-year-old member asked:
Dr. Jeremy Bland
Neuromuscular Medicine 40 years experience
It depends!: If you are talking about the same hand for a second time then true recurrences tend to occur 10-20 years after the original surgery and are quite rare. Failure of the first op is commoner and may need revision surgery quite soon. If you are talking about the other hand then CTS is bilateral in at least 70% of patients and operations on the other side are very common
90,000 U.S. doctors in 147 specialties are here to answer your questions, provide medical advice, write prescriptions, and more.
Answer emailed
in 24 hours or less