DEAR DR. DONOHUE: I have a problem with my wrist and fingers, in that they become numb quite frequently. The problem was once diagnosed as carpal tunnel syndrome. A wrist splint was prescribed, which is troublesome for me to wear.

I do no work that should cause the numbness. I wonder if the problem could be due to some other bodily problem that may need medical attention. I am 91 years of age and still work at carpentry and associated skills. — M.F.

ANSWER: Carpal tunnel syndrome involves a large nerve that travels down the arm and enters the hand through a tunnel in the wrist. The floor and sides of the tunnel are wrist bone. The roof is a tough, rigid ligament. The nerve doesn’t have much room in that tunnel. Inflammation of the tunnel causes swelling and compresses the nerve. The result is numbness, pain or weakness in the palm and fingers. The involved fingers are the thumb, index, middle and adjacent side of the ring finger.

Here’s a test for you to try. Firmly bend the involved wrist down and hold it in that flexed position for a full minute. If you have carpal tunnel syndrome, that maneuver should bring on numbness or pain. It’s not the be-all, end all test; it doesn’t always work. More sensitive and trustworthy tests are available.

Are you sure your carpentry isn’t the cause? How about taking a rest from it for a couple of weeks?

Body conditions not directly related to the wrist can bring on carpal tunnel syndrome. Pregnancy and menopause are two such conditions. Gout, a cancer called myeloma, rheumatoid arthritis, diabetes and a sluggish thyroid gland are other possible causes. It would be most unusual for carpal tunnel syndrome to be the only sign of these illnesses. They have distinctive signs of their own.

Try the wrist splint again. More comfortable and lightweight splints are found in medical-supply stores and some drugstores. Wear it only at night. You have to give it time — from weeks and weeks to months. A doctor can inject the area of the tunnel with cortisone to reduce the swelling.

DEAR DR. DONOHUE: I am an 88-year-old woman and have been diagnosed with lichen sclerosus. My genital area burns constantly. I have been using Clobetasol ointment for six weeks. I have had no relief. Is there any other treatment? What caused this condition? — V.B.

ANSWER: Many believe that the cause of lichen sclerosus is the immune system, which has turned on its own tissues, here the genital skin. Itching, burning and pain are three signs of it. The involved skin looks crinkled, and tiny splits appear on it.

Your current medicine is the one that is most often prescribed. It’s applied sparingly. A thin film is all that’s needed. Ask your doctor if daily use could be tried. It takes six to 12 weeks before a person sees improvement. Once you gain the upper hand, the applications can be spread out.

If Clobetasol doesn’t do the job, the doctor can inject the skin with different cortisone drugs.

Other medicines are prescribed, but for the time being, I think you’d be better off sticking with your current treatment.

DEAR DR. DONOHUE: I am 72. In the past 12 years I’ve completed 12 marathons. Last year I visited Spain with my son and stopped at a hostel in Spain for the night. I coughed so much that fellow pilgrims left. I decided to dump all seven prescriptions and supplements I had been using. Since then, I have been on a regimen of diet and exercise with no pills. My lab results are better than they were in the 10 years I took pills. — J.F.

ANSWER: I admire your grittiness. I do think we are an overmedicated people. However, I don’t think others should abandon their medicines without a discussion with their doctors. Medicines keep many people alive and functioning.

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.

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