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DEAR DR. ROACH: I had surgery late last year on my right wrist for carpal tunnel syndrome. The numbness in my fingers has not changed. Now I'm faced with the same problem in my left hand. I'm going to forget surgery, seeing as it wasn't successful in my right hand.
I decided to go to an acupuncturist for laser treatments. I also had a cortisone shot. Neither of these has helped. Do you know of a solution for my problem? — P.M.
ANSWER: Carpal tunnel syndrome is caused by compression on the median nerve, as it runs down the arm through a "tunnel" of bone and connective tissue deep in the wrist. It may cause pain, numbness and weakness of the wrist and hand. The thumb and middle three fingers are most often affected. In advanced cases, the hand muscles may become atrophied. The sooner the pressure on the nerve is relieved, the more likely there will not be permanent nerve damage.
It sounds to me like the first surgery was not done soon enough to prevent damage. If that's the case, then surgery on your left hand, done sooner after the onset of symptoms, might prevent the long-term numbness present in your right hand. However, it's possible that the diagnosis was wrong or that the surgery might not have been effective, even if done promptly.
At least one study of needle acupuncture showed that it is as effective as a cortisone injection. This study excluded people who already had fixed numbness in the fingers, who are less likely to be helped by any treatment. I have not found any evidence that laser treatment is effective.
My advice is to first be sure of the diagnosis. An EMG test is a study of nerve function, which can confirm the diagnosis and may be able to predict how much damage there is and provide guidance on treatment. If damage is not too severe, other treatments such as splinting, medication, yoga or ultrasound may be helpful. If advanced, surgery done quickly still may be your best bet.
DEAR DR. ROACH: I just found out that I have lipedema, a rare disease. What can I do about it? My mom and dad don't have it, nor other family. Should I try to find relatives who have it? I am told that it is an inherited disease. None of these "family" ever had it! —L.Q.
ANSWER: Lipedema is indeed a rare disease, although it may be underdiagnosed. It almost always is found in women, and is suspected when there is marked fat deposition symmetrically between the waist and ankles. The areas affected often are tender or painful to the touch. It is not the same as lymphedema, fluid increase due to poorly functioning or damaged lymph vessels, although people with lipedema can develop lymphedema.
Treatment includes compression garments or manual lymph drainage, often combined with surgical treatments such as liposuction.
Only about 15 percent of people with lipedema have a family history. It's not surprising that you can't find relatives with it.
More information is available at several support groups, and at curelipedema.org/lipedema.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]. To view and order health pamphlets, visit www.rbmamall.com, or write to P.O. Box 536475, Orlando, FL 32853-6475. (c) 2015 North America Synd., Inc. All Rights Reserved