For the past few months I have been experiencing numbness and tingling in the center, ring and little fingers, and palm of my left hand. It’s worse on the fingertips and the little finger feels the worst.
I have no pain or joint problems, but my fingers often feel cold. My right hand is fine. I’ve worked with computers all my life and am now in my mid-sixties.
Michael Albin, Blackburn, Lancs.
For nerve pain, I recommend avoiding prolonged elbow flexion — for example, always use the other hand to hold a phone, and don’t lean on the elbow when sitting or driving, says Dr. Martin Scurr
You have given a very clear description of a common condition called ulnar neuropathy. This is the point at which the ulnar nerve, which runs from the shoulder to the outer two fingers along the arm, becomes pinched, causing abnormal sensations such as tingling and, in some cases, weakness in the area supplied by the nerve .
The usual pinch point is around the elbow: the ulnar nerve moves in a groove near the medial epicondyle bone in the elbow and, when the elbow is bent, this stretches the nerve around this bone, which can irritate it.
(To find the medial epicondyle, stand with your arms at your sides, with the palm of each hand facing forward—it’s the bony point of the elbow closest to your lower ribs.)
Ulnar neuropathy of the elbow can be caused by something as simple as leaning on your elbow for a long time – or even sleeping on that side with the elbow bent. This usually leads to numbness and tingling in the 4th and 5th fingers.
Another possible bottleneck is Guyon’s canal: a canal in the wrist through which the nerve goes to the hand.
Nerve compression is often the result of repeated use of tools or intensive cycling (also called ‘steering paralysis’).
In addition to the sensory changes in the fourth and fifth fingers, this causes hand weakness, muscle wasting and loss of dexterity.
Wrap the elbow in a soft towel at night to limit flexion. This should solve the problem within a few weeks
Although your symptoms may resemble repetitive strain injury (RSI) – in which overuse of the muscles and nerves leads to pain, tingling and swelling – they are so characteristic of ulnar neuropathy, and the ulnar nerve is not usually involved in RSI, that I think this explanation is unlikely (not least because you no longer spend hours in front of a keyboard).
I suggest avoiding prolonged elbow flexion – for example, always use the other hand to hold a phone, and don’t lean on the elbow when sitting or driving.
Wrap the elbow in a soft towel at night to limit flexion. This should solve the problem within a few weeks.
For two years, I woke up in the early hours with a pounding heart that lasted for 30-45 minutes. This is made worse by the fact that I hear my heart beating all the time. I have also had tinnitus for 18 months. My blood pressure is low during the day (128/62 mmHg) but higher at night (153/76). I’m 70 and fit.
Name and address provided.
I sympathize, as these symptoms are clearly troubling you. But rest assured that nighttime palpitations – which they are – are usually not a sign of a medical problem.
The most common physical causes are dehydration (which reduces blood volume, making the heart work harder) and fever (as part of the body’s response to fighting infections).
But these seem unlikely explanations since you’ve had your symptoms for a while.
I would ask your doctor about a 24-hour continuous blood pressure monitor that also records your heart rate. If there is evidence of persistent high blood pressure, you may need an echocardiogram (an ultrasound scan of the heart).
But more often than not, nighttime heart palpitations are a manifestation of anxiety or depression. So if the tests are clear, I would suggest an appointment with a psychologist or therapist.
The most important thing I can tell you is that, based on the information you have given, it is unlikely that there is a problem with your heart. And I don’t see a close connection with your tinnitus.
Write to Dr. Scurr from Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: drmartin@dailymail.co.uk. Dr. Scurr cannot enter into personal correspondence. Answers should be taken in a general context. If you have health problems, consult your own doctor.
IN MY OPINION…Cutting corners can lead to tragedy
Last week it was reported that a young pregnant woman committed suicide after being told that the drug she was taking for severe morning sickness could potentially harm her unborn baby.
The inquest heard that the midwife she had contacted about a repeat prescription had sought advice from two medical colleagues before giving the patient incorrect information about the drug. Tragedy followed.
It’s a horrible story because a quick Google search would have revealed that the drug in question, doxylamine, is not known to be harmful to an unborn child.
Importantly, the available information also shows that anxiety is a possible side effect.
Severe morning sickness is a serious condition that requires significant support from the professionals involved with the patient – a clear example of where online or telephone consultations do not meet the demands of those caring for such a patient and making an accurate assessment. All the subtleties that are so clearly visible when you sit with a patient are lost when care is provided remotely.
What an unbearable example this story has been of the truth that austerity is not without costs.