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• Could you tell me what causes carpal tunnel syndrome?
  
  

  Could you tell me what causes carpal tunnel syndrome? - Helen, Roslindale, MA

  A malfunctioning nerve causes carpal tunnel syndrome. Nerves relay signals between the brain and body. In people with carpal tunnel syndrome, the signals have trouble passing through the relatively tight space of the carpal tunnel. The carpal tunnel is an area along the wrist. Increased pressure on the nerve in the tight carpal tunnel is the primary problem, but some medical conditions make nerves more likely to be affected by increased pressure (diabetes and thyroid disease, for example). Older individuals are also more likely to have carpal tunnel syndrome. We usually can't pinpoint the specific reason someone has carpal tunnel syndrome. Thank you for your question! Andrew Terrono, MD, Hand Surgeon

  
  
  
• My right hand, index finger and the joint, are very painful.What can I do to maintain the function I have and alleviate pain for a longer period than a couple of hours?
  
  

  My right hand, index finger and the joint, are very painful. I am a graphic designer and writer and use the 'mouse' a lot. What can I do to maintain the function I have and alleviate pain for a longer period than a couple of hours? I already take 75mg of Volteran. I plan to work for at least 8 more years. Are cortisone shots used for this? Because cortisone weakens the tendons, is this an option? I have not seen any doctor except my family doctor. Should I go to a specialist? -Mary, West Boylston, MA

  You may wish to consult a hand surgeon. Cortisone injections are not a long-term option and may lead to further degeneration of the joint. First, a diagnosis must be made to determine what is causing your pain and disability. Once this has been done, a plan for treatment can be considered. This may include some type of recommendation for changing your pain medications and arthritis medications or it may include a surgical corrective procedure. Thank you for your question! Hervey Kimball, MD, Hand Surgeon