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Dr Uzair
Dr Uzair, Doctor
Category: Medical
Satisfied Customers: 6957
Experience:  MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
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. I am a 71 year old female, slim and in good health eating

Resolved Question:

. I am a 71 year old female, slim and in good health eating a healthy diet. Very active - working from 6a.m. -9p.m. often outdoors. On lowest dose possible of lisinapril and simvastatin and chloresterol. About 2 years ago I started experiencing a numbness in my fingers at night. Both of my parents had heart problems so I had my heart checked by my GP and was told my heart was fine. More recently I had a badly infected cat bite and was given a thorough check at the hospital, including an angiogram. Again all was fine. The discomfort in my fingers is now keeping me awake at night but disappears as soon as I get up. If I hang my arms out of the bed the pain goes away but I cannot sleep in this position. Can you give me an indication of what might be causing this please?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr Uzair replied 2 years ago.
Dr Uzair :

. Welcome to JustAnswer. I shall try my best to assist you while you are corresponding with me.

Dr Uzair :

So, which fingers are mostly affected, the thumb, index, middle and half of the ring, or the little and the half of the ring finger?

Dr Uzair :

Please enter chat and use reply to respond.

Customer:

Do you have my query to hand

Dr Uzair :

Yes I do.

Dr Uzair :

This seems like nerve compression neuropathy.

Dr Uzair :

If you can answer a few questions, I can try to localize this.

Dr Uzair :

Please tell me which fingers are involved?

Customer:

All fingers, both hands.

Dr Uzair :

Okay. Do you have any cold intolerance, weakness of the grip?

Customer:

No

Dr Uzair :

Alright, does the pain affect other parts of the upper limb above the wrist?

Customer:

no

Dr Uzair :

Okay. This seem like a carpal tunnel syndrome with a guyon's canal neuropathy.

Dr Uzair :

Both the ulnar and the median nerve are compressed at the level of the wrist.

Dr Uzair :

The symptoms you have are typical of them.

Customer:

Is this treatable and if so how please

Dr Uzair :

I would suggest a consultation with a Hand surgeon or a plastic surgeon specialized in hand surgery . A clinical examination, provocative tests (clinical) and electrodiagnositc work up including a nerve conduction study and electroencephalogram are in order.

Dr Uzair :

Yes, this is treatable.

Dr Uzair :

Depending on the severity, it can either be treated with splinting alone

Dr Uzair :

And in the other case a minor day care procedure of release done under local anesthesia.

Dr Uzair :

Do you have any other queries?

Customer:

Thank you. I do not understand why the pain only occurs when I am lying down and not when I am working during the day.

Dr Uzair :

This typically presents at night after a whole day of activity and provocation of the nerves, during work, there is distraction so symptoms are masked.

Dr Uzair :

At night, the pain presents because of the inactivity of the hand in resting position and the tunnels becoming tight due to relaxed tendons and lumbrical muscles and swelling of the nerve.

Dr Uzair, Doctor
Category: Medical
Satisfied Customers: 6957
Experience: MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
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