DR. MARTIN SCURR: The surprising causes of pins and needles in your hands – and what you can do about them

I have been experiencing pins and needles in my left hand lately. Often my fingers are so numb that I can press them together and feel nothing. I also get pain in my elbow. What could this be? I’m 66.

Michael O’Donnell, by email

The fact that the tingling and numbness in your fingers occurs along with pain in your elbow suggests that the cause is a problem with the ulnar nerve.

This nerve, which runs in a groove near your elbow, helps you move your forearm, hand, and certain fingers (particularly the pinky and ring fingers, but also the middle finger). It also sends information about touch, temperature, and pain to your brain.

When people “hit their funny bone,” which can be both excruciating and strangely numbing, they have actually hit the ulnar nerve in the canal at that spot.

A typical cause of tingling and numbness in your pinky and ring fingers is prolonged flexion of the elbow. Sometimes I see this in patients who sleep on one side with their elbow bent. However, this is usually quickly resolved within a few minutes by straightening the arm.

Another, but much less likely cause is arthritis of the elbow. This is rare and in any case does not normally affect the ulnar nerve.

I am wondering if you have had a previous injury to your elbow and if gradual scar tissue can cause irritation in this area of ​​the ulnar groove. I would suggest you ask your GP for a thorough examination of this area.

I recently had a blood test at my primary care physician and was told my kidney function is 27—which, after looking at Dr. Google, seems very serious. How do I address this problem? And is it a precursor to dialysis or a kidney transplant? I am 67, eat a balanced diet, walk 2-4 miles a day, and do not overeat or drink.

Barry Cooper, Woking

Our kidney function is typically assessed by measuring our estimated glomerular filtration rate, or eGFR.

It is literally a measure of how well your kidneys are filtering waste and excess fluid from your body, which is reflected in blood tests. The normal eGFR in a healthy young adult is 80 to 120. And while our GFR decreases with age, a measurement of 27 suggests the problem here is chronic kidney disease (CKD).

This is an increasingly common condition that affects more than seven million people in Britain, but it often goes undiagnosed for too long as patients usually experience no symptoms initially.

As the disease progresses, it can lead to shortness of breath and fluid retention (causing swollen ankles, feet or hands and high blood pressure), as well as fatigue. Common causes include long-term diabetes or a history of high blood pressure (both of which can damage the small blood vessels in the kidneys) – as well as risk factors for heart disease, such as high cholesterol and smoking (again, because these can cause damage to the blood vessels).

Other possible triggers include heart failure, obesity and recurrent urinary tract infections.

Chronic kidney disease is a common condition that affects more than seven million Britons, but often goes undiagnosed because patients initially experience no symptoms

In my opinion, you should be referred to a nephrologist, have a renal ultrasound and possibly further investigation, possibly a renal biopsy.

Although the discovery of your low eGFR is concerning, whether you need kidney dialysis depends on several factors. It is possible that there are other treatment options that can stop the decline in your function.

Please feel free to write to us again after your examination and urge your GP to refer you as soon as possible.

In my opinion… Serious risks of online prescriptions

As a doctor, I am not allowed to prescribe drugs to my own family. I say ‘not allowed’, but it is not actually illegal – it is just highly frowned upon and can end up with a kind of rap on the knuckles from the regulatory body, the General Medical Council.

The reason for this is that, no matter how well-motivated, my judgment may not be impartial when it comes to my nearest and dearest and could inadvertently endanger their health. Additionally, I may not be aware of things in their personal medical history that are relevant to their condition. So why are doctors allowed to prescribe medications to patients they have never seen based on an online or telephone consultation? Details of medical history are all too easily omitted, either because the patient does not recognize their relevance or to hide something.

For example, we know that young women with fatal eating disorders are getting their hands on supplies of the revolutionary slimming drug semaglutide in this way.

I once came across a young student who was addicted to the sleeping tablet zopiclone, which he had been receiving for years through various online consultations. I worry that the regulators are letting this slip through the cracks – until something terrible wakes them up.