DR MARTIN SCURR: What’s causing pins and needles in my fingers?

Over the past few months I’ve been getting numbness and pins and needles in the middle, ring and little finger and palm of my left hand. It’s worse at the end of the fingertips and the little finger feels worst of all.

I don’t have any pain or joint issues, but my fingers often feel cold. My right hand is fine. I worked with computers all my life and I’m now in my mid-60s.

Michael Albin, Blackburn, Lancs.

For nerve pain, I suggest avoiding prolonged elbow flexion — for example, always use the other hand to hold a phone, and don’t lean on the elbow when seated or driving, says Dr Martin Scurr

You’ve provided a very clear description of a common condition called ulnar neuropathy — this is where the ulnar nerve, which runs down the arm from the shoulder to the outside two fingers, becomes pinched, triggering abnormal sensations such as tingling and, in some cases, weakness in the area supplied by the nerve.

The usual pinch point is around the elbow: the ulnar nerve travels in a groove close to the medial epicondyle bone in the elbow and, when the elbow is bent, this stretches the nerve around this bone, which can irritate it.

(To find the medial epicondyle, stand with your arms by your side, with the palm of each hand facing forwards — it’s the bony point of the elbow closest to your lower ribs.)

Ulnar neuropathy of the elbow can be caused by something as simple as leaning on your elbow for a prolonged period — or even sleeping on that side with the elbow bent. Typically it leads to numbness and tingling in the 4th and 5th fingers.

Another potential pinch point is the Guyon’s canal — a channel in the wrist through which the nerve travels to the hand.

Nerve impingement here is often the result of repetitive use of tools, or intense cycling (when it’s known as ‘handlebar palsy’).

As well as the sensation changes in the fourth and fifth fingers, this causes hand weakness, muscle wasting and loss of dexterity.

 At night, wrap the elbow in a soft towel in order to limit flexion. This should help resolve the problem in a matter of weeks

While your symptoms might sound like repetitive strain injury (RSI) — where overuse of the muscles and nerves leads to pain, tingling and swelling — they are so characteristic of ulnar neuropathy, and the ulnar nerve is not usually involved in RSI, that I think this explanation is unlikely (not least as you’re no longer spending hours on a keyboard).

I suggest avoiding prolonged elbow flexion — for example, always use the other hand to hold a phone, and don’t lean on the elbow when seated or driving.

At night, wrap the elbow in a soft towel in order to limit flexion. This should help resolve the problem in a matter of weeks.

For two years, I’ve been woken in the early hours with a pounding heart, lasting for 30-45 minutes. This is compounded by hearing my heart beat all the time. I’ve also had tinnitus for 18 months. My blood pressure is low in the day (128/62 mmHg) but higher (153/76) at night. I’m 70 and fit.

Name and address supplied.

I sympathise, as these symptoms are clearly causing you concern. But please be assured that nocturnal palpitations — which is what these are — are not usually the sign of a medical problem.

The most common physical causes are dehydration (which lowers blood volume, so the heart has to work harder) and fever (as part of the body’s response to fighting infection).

But these seem unlikely explanations as you’ve had your symptoms for some time.

I’d ask your GP about a 24-hour continuous blood pressure monitor which will also record your heart rate. If there’s evidence of a sustained high blood pressure, you may need an echocardiogram (an ultrasound scan of the heart).

But more often than not, nocturnal palpitations are a manifestation of anxiety or depression. So if the tests are clear, I’d suggest an appointment with a psychologist or therapist.

The most important thing I can tell you is that on the information you’ve given, it is unlikely that a problem with your heart is the issue. And I don’t see any close link with your tinnitus.

Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: [email protected]. Dr Scurr cannot enter into personal correspondence. Replies should be taken in a general context. Consult your own GP with any health concerns.

IN MY VIEW… Cutting corners can lead to tragedy

Last week it was reported that a young pregnant woman committed suicide after being advised that the drug she was taking for severe morning sickness could potentially be harmful to her unborn baby.

At the inquest it emerged that the midwife she’d contacted about a repeat prescription had sought advice from two medical colleagues before she gave the patient incorrect information about the drug. Tragedy followed.

It’s an appalling story, for a quick Google search would have shown that the drug in question, doxylamine, is not known to be harmful to an unborn child.

Importantly, the available information also states that anxiety is a potential side-effect.

Severe morning sickness is a serious condition requiring considerable support from the professionals involved with the patient — a clear example of where online or phone consultations are not up to the demands of those caring for such a sufferer, and making an accurate assessment. All of the subtleties that are so evident when sitting with a patient are lost when care is given remotely.

What an unbearable example this story has been of the truth that cutting corners is not without cost.