Pain Archive

Ignoring symptoms of this carpal tunnel syndrome can lead to permanent nerve damage.

First, you may notice tingling or numbness in your fingers that comes and goes. Over time, the sensations may get worse, lasting longer or even waking you up at night. Eventually the pain and numbness might even make it hard to grip things like a fork, a pen, or other objects.

If you're having these symptoms, it could be carpal tunnel syndrome, which occurs when the median nerve — which runs down your arm and into your hand — is compressed by a ligament that crosses over it as it passes through a narrow space in the wrist known as the carpal tunnel.

People who get frequent headaches and need to take medication at least 15 days a month may be at risk for medication overuse headaches, or “rebound headaches.” Treatment depends on the medication being taken.

The primary purpose of your legs is to keep you upright and mobile. Yet, your legs can also act as an indicator of your overall health. Although some symptoms you may experience are specific to a leg problem, others can suggest trouble with your heart, nervous system, kidneys, or other organs. Use the following symptom guide to help you decipher what broader problems your leg pain might suggest.

Symptom: Leg cramps
Possible cause: Dehydration

A cramp in your leg after you've been working out, especially in the heat, could be an important sign that your body is low on fluids. To contract and relax normally, muscles rely on water and electrolytes like sodium and potassium. Too little fluid or electrolytes can hypersensitize the nerves that control muscles in the legs, causing the
muscles to contract abnormally, or spasm.

News briefs

Last month we told you about new medications to treat migraine headaches. Now a small Harvard study published Aug. 8, 2019, in The American Journal of Medicine offers a reminder about the importance of limiting migraine triggers. For six weeks, 100 adults with frequent migraines were asked to record daily intake of caffeinated coffee, tea, soda, and energy drinks; alcohol intake; activity levels; stress; and sleep times. They also recorded their headache episodes. Researchers looked at each study participant's risk of having a headache on a given day in relation to his or her consumption of caffeinated beverages. Having three or more servings of caffeinated drinks in a day was associated with higher odds of having a migraine on that day or the following day. However, having one to two servings of caffeinated beverages was not associated with migraines. Does that mean people prone to migraines can safely enjoy up to two caffeinated drinks per day? Not quite. The study is only observational and doesn't prove that any amount of caffeine will or won't cause migraines. But if you are prone to migraines, watch your headache triggers, and perhaps keep a journal of daily activity (including caffeine intake) to help discover your trigger limits.

Image: Mike Watson Images/Getty Images

On call

Q. I suddenly developed low back pain for the first time. My doctor said I did not need an x-ray or other imaging test. Is that normal and are there any situations when a test would be needed?

A. Yes, your doctor is following the current guidelines. Unless you have other symptoms in addition to low back pain, an x-ray, CT scan, or MRI is not likely to be helpful. But it could cause unnecessary worry while waiting for the results and cost you some money if it's not covered by your health insurance. In addition, many people have "false-positive" results in which an abnormality is detected but turns out to be harmless.

Can you do anything about hand and finger joint pain?

Everyone experiences the occasional painful hands and sore fingers, but when osteoarthritis strikes, it can put a hold on many aspects of your life.

"As osteoarthritis progresses, you may lose some hand mobility, like the ability to grasp and hold objects," says Dr. Robert Shmerling, clinical chief of rheumatology at Harvard-affiliated Beth Israel Deaconess Medical Center and senior faculty editor at Harvard Health Publishing. "Over time, osteoarthritis can make the joints deformed, so it's harder to open and close your hands."

Most children have an occasional headache, but some children get recurrent headaches. These often run in families and may be migraine or tension headaches or might stem from other causes.

Dyspareunia is a common problem for many postmenopausal women.

Millions of women experience pain before, during, or after sexual intercourse—a condition called dyspareunia (from the Greek dyspareunos, meaning "badly mated"). This condition not only saps sexual desire and enjoyment, it can also strain relationships and erode quality of life in general. For postmenopausal women, dyspareunia may also raise concerns about aging and body image.

Many women suffer in silence and don't seek the help they need, or they have trouble finding a clinician who can diagnose and treat the causes of their pain. That is unfortunate, because treatments are available for many of the problems that underlie this vexing condition.

Doctors say three recently approved migraine prevention drugs are helping people have fewer headaches.

For people with frequent, debilitating migraine headaches, 2018 brought encouraging news. The FDA approved three new medications — erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality) — the first drugs designed specifically to prevent migraines and reduce their frequency, intensity, and duration.

It was a big development, since other medications used to stop migraines were created to control other conditions, such as seizures, depression, high blood pressure, or an irregular heartbeat. But their side effects (such as weight gain, dizziness, or fuzzy thinking) often cause people to skip treatment.

The extract from the cannabis plant is the hot new treatment for all kinds of ailments, but don't buy into it just yet.

Cannabidiol (CBD), extracted from the cannabis or hemp plant, has been promoted as the latest miracle cure for everything from aches and pains to anxiety and sleep disorders. There is a good chance you've heard a friend share his or her story about the wonders of CBD.

But is it miraculous — or just a mirage?

"CBD is being used over the counter in a range of ways that is not supported by the science," says Dr. Jordan Tishler, instructor of medicine at Harvard Medical School and president of the Association of Cannabis Specialists. "There is still much we don't know. But aggressive marketing, hype, and word of mouth have made CBD like a drug version of the emperor's new clothes. Everyone says it works, but lab studies suggest that it's really not what people think."