Dr. Anshul Varshney
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
Six months back I was diagnosed by two doctors and tests with carpal tunnel syndrome (CTS). The suggestion was to go for an operation which regretfully I delayed until recently. The symptoms got worse. Now I have an appointment next month with a specialist. Meanwhile, I have pins and needles in the most upper part of my arm, basically in the shoulder for 15 to 20 minutes. They come totally unexpected, whether I move or not. They appear up to 15 times, typically in the morning when getting up. There is no pain, it is just very unpleasant and frightening since I cannot control it. Secondly, during the night when in bed my neck becomes very stiff, causing pain to wake me. A new medical cushion has not helped. My question is that are both symptoms related to CTS since I always thought this is located to the hand only. Can I expect relief after the operation or could this be something different? Currently, I am taking Atorvastatin, Atenolol, Exforge, Tamsulosin, Allopurinol.
Hi,
Welcome to icliniq.com. Carpal tunnel syndrome will not cause any symptoms in the upper arm. However, it could be due to cervical nerve compression. This could be associated with or without the carpal tunnel syndrome independently. In my opinion, you should go for nerve conduction velocity nerve conduction velocity (NCV) testing to be sure.
Patient's Query
Hello doctor,
Thank you for the quick answer. Should I go for the nerve conduction velocity nerve conduction velocity (NCV) testing before or after the operation next month? My thyroid is fine.
Hi,
Welcome back to icliniq.com. I suppose you should go for nerve conduction velocity (NCV) prior to surgery. If you have any further query please ask me.
Patient's Query
Thank you doctor,
I think I should contact my consultant first and describe to him the new symptoms I have. Actually, an nerve conduction velocity (NCV) study was made six months back and resulted in the diagnosis of severe carpal tunnel syndrome (CTS) and the suggestion to operate which regretfully I delayed. A new NCV has to be initiated by the same doctor who will perform the operation. What do you think? Also, in your first reply, you stated that this could be associated with or without carpal tunnel syndrome independently. This statement leaves room for a second opinion, with all respect. Please advise.
Hi,
Welcome back to icliniq.com. Since your nerve conduction velocity (NCV) is suggestive of carpal tunnel syndrome (CTS), then it must be there. So, I suppose you would require surgery for CTS. Since you mentioned symptoms in the upper arm, so I considered cervical radiculopathy. To be honest, a clinical examination is a must. A good clinical examination rules out most of the things. So, you should discuss with your doctor, let him examine and if he feels, he would order magnetic resonance imaging (MRI) for you.
Patient's Query
Thank you doctor,
I understand much better now. I overlooked that this can occur independently carpal tunnel syndrome (CTS) and nerve compression in the neck. I had at first not understood. I will see my doctor but meanwhile the last question, could you advise any oral medication for my condition, it is no doubt cervical radiculopathy.
Hi,
Welcome back to icliniq.com. Yes, I personally prefer to use a combination of Pregabalin and Methylcobalamin in such radicular pains until I get the magnetic resonance imaging (MRI) report. I find results very satisfactory (attachment removed to protect patient identity). You can ask your doctor to prescribe you that for a few days.
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Internal Medicine
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