DEAR DR. DONOHUE: Please give me any information you have on carpal tunnel syndrome. I do not want anyone to cut me. Are there other ways to relieve the pain? — L.A.

ANSWER: The carpal tunnel is a real wrist tunnel whose bottom consists of bone and whose top and sides are ligaments. Running through the tunnel are finger tendons and a large nerve that serves the thumb, the index and middle fingers, and part of the ring finger. It’s a snug fit for all these structures. When anything else adds to the crowded conditions — for example, swelling or ligament thickening that comes with age — problems arise.

Work that requires repetitive finger and hand movements can lead to tunnel inflammation, adding to encroachment on the nerve. Carpenters hammering or twisting screwdrivers are set up for becoming carpal tunnel patients. The added pressure in the tunnel squeezes the nerve and creates tingling or pain in the fingers supplied by that nerve. Weakness of the fingers can result. The pain worsens at night.

Rest is one of the best treatments for carpal tunnel syndrome. Rest is achieved by wearing a wrist splint, available in many places, including most drugstores. Limiting splint time to the night often is enough to effect a cure. If it’s possible, night and day wear is more effective. Anti-inflammatory medicines such as Aleve and Advil lessen pain and inflammation if a person has no contraindications to their use, like stomach irritation or past history of ulcer. A doctor can inject the tunnel with one of the cortisone medicines, and that often brings quick relief. You want no cutting, but let me mention some surgical procedures for others who have this common problem. If pain, numbness or weakness persists in spite of the above conservative measures, then surgery ought to be considered. A skin incision exposes the tunnel ligament roof, and it can be incised to give the nerve breathing space. Many variations of the procedure are available. One is a 15-minute technique that cuts through the skin and the thickened tissue via a small cut. Its appeal is simplicity, but it is not the answer for all patients.

DEAR DR. DONOHUE: How important is it for a person to have a balanced acid-alkaline body? I test my urine with a pH paper and, when I am on the acid side, I correct it with baking soda. I feel I am in perfect health. I wonder how many know if their body is too acid or too alkaline. Would they benefit by knowing their pH? — M.B.

ANSWER: The pH scale reveals acidity or alkalinity in numbers ranging from 1 to 14. Seven indicates neutrality, neither acid nor base (alkali). Numbers below 7 are in the acid range; those above are in the alkali range. The body carefully guards blood pH at 7.35 to 7.45, slightly on the alkaline side. It preserves it at this level through blowing out or retaining carbon dioxide, through kidney excretion of acid or bases, and through its store of buffers — chemicals on hand that neutralize acids and bases. Normal urine pH varies from the acidic of 5 to the alkaline of 9. It doesn’t give an accurate idea of current blood pH. It does show that the body is doing its job in keeping blood pH in its normal, small range.

If you want to keep testing, then you can. A very smart doctor once told me not to discourage people from doing things that do no harm but aren’t truly necessary. Some popular information runs counter to what I just said. It encourages people to tinker with their pH. The tinkering doesn’t usually cause any trouble, but it doesn’t promote health.

DEAR DR. DONOHUE: Please discuss bile reflux. My son has it. — E.L.

ANSWER: The gallbladder ejects bile into the small intestine to aid in fat digestion. Sometimes the bile leaks into the stomach and esophagus — bile reflux. A tipoff that this is occurring is a person with heartburn who doesn’t respond to the usual medicines for heartburn. In a few medical centers, the presence of bile is detected through special equipment. Baclofen has been proposed as treatment for bile reflux.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.