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Suggest Treatment For Pain And Numbness In Both Hands

Posted on Fri, 11 Apr 2014

Question: My father (age 65) has pain and numbness in his both hands and it is very severe such that he is not able to move his fingers and hold anything properly. He has spondylitis as well and has undergone angioplasty. I am not sure he has CTS or the pain in hand is due to spondylitis I am attaching the reports for MRI and nerve tests. Please advice on the next steps and is there any medication or surgery to be performed.

Answered by Dr. Sudhir Kumar (2 hours later)

Brief Answer: Symptoms are more likely due to CTS. Detailed Answer: Hi, Thank you for posting your query. I have noted the symptoms, MRI and nerve conduction study reports of your father. Based on them, the most likely cause of his symptoms is carpal tunnel syndrome (CTS) due to compression of median nerves at the level of wrists. Initial treatment is with gabapentin or pregabalin capsules. If medications do not help, a minor surgery (carpal tunnel decompression) may be done with good success. I hope my reply has helped you. I would be pleased to answer, if you have any follow up queries or if you require any further information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar My blog: http://bestneurodoctor.blogspot.com/

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (18 hours later)

Hello Doctor, Thanks for your reply. I have following questions: 1. Will this capsule be available in any medical stores and What should be the dosage for the medicine you prescribed 2. We consulted a neuro surgeon in XXXXXXX Hall Clinic in Pune and he said that carpal tunnel decompression surgery will not help in relieving the pain in hands since he has spondylitis, what do you think whether we should go for surgery if medicine does not help or can you suggest treatment/medication for spondylitis/survical as shown in MRI report that can cure CTS indirectly. 3. Can you suggest some doctor/hospital for doing the surgery in India (preferably Pune/Mumbai) Thanks XXXXX

Answered by Dr. Sudhir Kumar (15 hours later)

Brief Answer: My reply is below. Detailed Answer: 1. Pregabalin is available in medical stores. The common brands available are lyrica, pregalin and pregabid. The usual dose is 75 mg one to two times daily. Gabapentin is sold in brand names gabapin and galantine. The usual dose is 300 mg two to three times daily. 2. In my opinion, you should go for surgery, if medicine does not help. However, you should rely more on a doctor who has had a chance to examine your father personally. Same medicines will help in spondylitis too. 3. It is a simple surgery and any neurosurgeon can do that, often as a day care procedure. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (37 hours later)

Hello Doctor, Thanks for the reply. I have few more questions 1. Are there any side effects after the surgery and what are the risks involved as you already know he his a heart patient and has BP as well. 2. He takes BP and heart medicine daily, are there any side effects of this medicine n them. I am also inclined towards the surgery, what is the success rate for the surgery.

Answered by Dr. Sudhir Kumar (9 hours later)

Brief Answer: Surgery is fairly safe. Detailed Answer: Thank you for getting back. Surgery is fairly safe and there are no side effects or complications. In a person with high BP and heart ailment also, this surgery can be safely done, as it needs only local anaesthesia (and not general anaesthesia). Surgery benefits more than 90% people. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar