Ask the Doctors May 2019 Issue

Ask The Doctors: May 2019

Q: I have numbness and tingling in my fingers. My doctor tells me I have carpal tunnel syndrome. For my job, I do a lot of typing. Did that cause my problem?

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Arthritis Advisor Editor-in-Chief Steven Maschke, MD, Department of Orthopaedic Surgery, Cleveland Clinic Orthopaedic & Rheumatologic Institute.

A: We used to think that repetitive motion, such as typing all day, was a main cause of carpal tunnel syndrome. While carpal tunnel syndrome can have several possible causes, the evidence suggests that overuse of a keyboard is probably not to blame.

Carpal tunnel syndrome occurs when there is inflammation in the passageway (the carpal tunnel) through which the median nerve travels from the forearm into the palm of the hand. This nerve provides feeling to the thumb and index and ring fingers. Inflammation in the canal can compress the nerve, causing tingling, numbness and weakness in those fingers. Symptoms often wake people up at night, making them feel like they want to shake it off.

Inflammation in the carpal tunnel may result from trauma to the wrist or a health condition, such as rheumatoid arthritis and diabetes. Obesity, hypothyroidism, being sedentary and smoking can increase your risk. Often, the cause of carpal tunnel syndrome is not known.

Carpal tunnel syndrome is treated by avoiding activities that provoke symptoms and wearing a wrist splint at night. A corticosteroid injection may help as well. For severe cases, surgery is an option.

Even though repetitive motion from typing probably didn't cause your carpal tunnel syndrome, you should pay attention to correct posture and wrist position when typing. You can get a repetitive stress injury, which usually relates to inflammation of the tendons (tendonitis), from long sessions at the keyboard. A repetitive stress injury can make symptoms of carpal tunnel syndrome worse.

Q: I have a question about the article "Nourishing Nuts and Seeds" in the March issue. I've been told that peanuts are not nuts. They are in the bean family. I hope peanuts are good for you because I enjoy peanut butter. Also, which nuts are most nutritious?

A: Peanuts are indeed in the same family as beans. They are both legumes, which is a type of plant with edible seeds or pods. Other legumes are chickpeas, lentils and soybeans. Like the other legumes, peanuts have good nutritional value, as do nuts and seeds.

Regarding which nuts are most nutritious, they all are. Each has a different composition of nutrients. Therefore, eat a variety of them. The widest possible variety of foods of all kinds will confer the greatest advantage and likelihood of being well nourished. That is true for nuts, beans, greens, fruits, vegetables, and other foods. No single food, no matter how nourishing, provides the advantages of a mixture.

Q: What are the first signs of osteoarthritis?

A: Osteoarthritis starts when cartilage (the covering over the ends of bones in joints that allows for smooth movement) breaks down and thins. This leads to damage to other structures in and around the joint and inflammation. This causes joint pain, stiffness and swelling. Symptoms often start slowly and get worse over time. Sudden severe joint pain is probably caused by something else. At first, joint pain of osteoarthritis might come and go and the pain level can vary. As arthritis worsens, the joint can stiffen, especially after long periods of sitting or lying down. There's no cure, but it can be treated.

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